You must have JavaScript enabled to use this form. Please check this box to indicate your understanding that you may not complete this form after the last date to withdraw from your class has passed. From Title - Select -Dr.Mr.Mrs.Ms. First Name Last Name Email Address of Referring Instuctor Submitting Person's Email Address More If someone other than the referring instructor or dean is submitting this form, then please enter your email address. School of - Select -Frank S. Groner School of Professional StudiesFred Hale School of BusinessChristian StudiesCommunication and Performing ArtsEducationHumanitiesNatural and Social SciencesNursing Date and Time Submitted Sunday, April 28, 2024 - 06:57 General Student Information Student Contact Information Student Last Name Student First Name Student email address Advisor's Name Professor Teaching Course Team Name (if applicable) Course number Course Name Dates of Absences Last Date Attended Class Check one Check one - Select -MWFTROther…(please explain) Other…(please explain) Current Grade in Course | Please use a number instead of a letter Email Address of Dean over specified course More This form will automatically be sent to the specified Dean for approval.
