UNIVERSITY OF SAN AGUSTIN

COLLEGE OF NURSING
ILOILO CITY

Date_______________________

EXCUSE SLIP

TO WHOM IT MAY CONCERN:

My _________________________________________________________________________
(Name of Son/Daughter) (Year/Section)

has been absent for __________________days from ______________ to _____________________ at

(Date) (Date)
_________________ to _____________________ because ____________________________________
(Time) (Time)
____________________________________________________________________________________
Indicate if Doctor’s certificate is submitted YES___________ NO _________________

Excused____________________________ Unexcused _______________________

__________________________ ______________________________
Guidance Counselor’s Signature Parent/ Guardian Signature

Subject/Clinical Area Teacher’s Signature

__________________________ ________________________________
__________________________ ________________________________

-------------------------------------------------------------------------------------------------------------------------------

UNIVERSITY OF SAN AGUSTIN

COLLEGE OF NURSING
ILOILO CITY

Date_______________________

EXCUSE SLIP

TO WHOM IT MAY CONCERN:

My _________________________________________________________________________
(Name of Son/Daughter) (Year/Section)

has been absent for __________________days from ______________ to _____________________ at

(Date) (Date)
_________________ to _____________________ because ____________________________________
(Time) (Time)
____________________________________________________________________________________
Indicate if Doctor’s certificate is submitted YES___________ NO _________________

Excused____________________________ Unexcused _______________________

__________________________ ______________________________
Guidance Counselor’s Signature Parent/ Guardian Signature

Subject/Clinical Area Teacher’s Signature

__________________________ ________________________________
__________________________ ________________________________