REQUESTED ABSENCE

This form must be completed in advance of the requested absence and approved by the Programme
Leader. For medical absence you should use a different form.
Student name: Pham Hoang Phuc Date of birth: 18/07/2004
Student ID number: Cohort/Class:
Email: hoangphucpham83@gmail.com Mobile number: 0935026203
Details of absence(s) as bellow:

Date(s) Module Absent Name of teacher/

hour lecturer
26 July 2107 IELTS Intensive Intermediate 13:00 to Jed, Micheal
17:00

Please kindly describe clearly the reason for your requested absence:
I have to do the final exam at school
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□ Evidence:
I hereby certify that the information provided above is true. I understand that providing false
information and evidence to the Student Support Officers is Academic Misconduct and may affect
my entitlement to take assessments for the respective module(s).
Student’s signature Pham Hoang Phuc Date 26 July 2021
Received by (SSO) Date
SSO Note:
Date
Academic Compliance Office’s Approval Date
_
Note: Student must submit this form together with evidence if appropriate in advance of their requested absence. This form may not be
used retrospectively. This form is a request and is only valid and granted if agreed and signed by your Programme leader prior to your
absence. Copies of this form are sent to the authorised parent / fee payer if requested. Please complete this form carefully as it will
form part of your student file and is available to authorised persons requesting references on your academic performance.

Updated 14 Jan 2020