KENTUCKY STATE UNIVERSITY
SCHOOL OF NURSING
400 EAST MAIN STREET FRANKFORT, KENTUCKY 40601
BETTY WHITE HEALTH CENTER
Appendix E: Request to Make-up Missed Work
Name (Please Print)
ID Number
Date of Absence
Date of Request
REQUEST MUST BE MADE ON THE DAY THE STUDENT RETURNS TO COURSE FOLLOWING THE ABSENCE. Reason for Request
Clinical absence
Theory absence that resulted in a missed test
PLEASE ATTACH VALID EXCUSE/REASON FOR ABSENCE.
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Faculty's Approval for Make Up
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Date of Faculty's Approval
Date/Time/Location for Make-Up Work
<div style="text-align: center;"><img src="imgs/img_in_image_box_26_27_912_86.jpg" alt="Image" width="94%" /></div>
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Comments:
Student's Signature ___
Date___