Instructions for Student:

       Attach by staple, an official excuse document such as a physician's note or college administrative form, if available.
Invalid excuses will not eliminate a penalty. After your instructor has signed this form, make a photocopy of this
document for your records and give the original  to your instructor.

To be completed by student:

LAST NAME________________________, FIRST NAME__________________________

YOUR LAB SECTION NUMBER_________________.

DATE OF MISSED LAB:__________________.     LAB EXERCISE MISSED:  __________.

REASON FOR MISSING LAB:

___________________________________________________________
 

___________________________________________________________

I agree to follow the make-up procedure described below and to submit the completed lab work to the instructor
in a reasonable amount of time.  I understand that unless this is done to the satisfaction of my instructor, I will
suffer a loss of 25 points from my total course points that will determine my course grade.

Student's signature ___________________________Date ____________

To be completed by instructor:

Make-up Procedure:
 
 
 

Instructor's Signature:_________________________