department of intercollegiate athletics

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DEPARTMENT OF INTERCOLLEGIATE ATHLETICS STUDENT ATHLETE EXCUSED CLASS ABSENCE FORM Name of Student-Athlete : (print) _________________________Team:__________________ Scheduled Class Name of Professor

: (print) _______________________Date:_________Time:_______ : (print) ________________________________________________

The above named student athlete at Piedmont College is requesting an excused absence from the above named class on the following dates to participate in an intercollegiate athletic contest(s) while representing Piedmont College:

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List Dates and Times: 1. ______________________________________________________________________ 2.

______________________________________________________________________

3.

______________________________________________________________________

4.

______________________________________________________________________

5.

______________________________________________________________________

6.

______________________________________________________________________

*Alternate absences may occur due to weather or post season competition.

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All student athletes are required to make up any missed work from class. Arrangements should be made with each professor to fulfill this requirement.

Failure to return this form with all signatures to the athletic department within the first 2 weeks of the semester will result in the immediate suspension of playing privileges.

Signature of Student-Athlete: Signature of Professor: Signature of Head Coach:

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