Class Exception Request

Students are not permitted to work during scheduled class times with limited exceptions. Complete this form if you worked during a scheduled class time and believe you have an acceptable exception. Example: Class was canceled.

Your Name *
Your name

Your Email Address *
Your email address *

Provide the date and class start and end time of the shift you have (or wish to) work. Include as much detail as possible. (e.g. Tuesday, April 12, 2A - 2:25 pm - 4:15 pm) *
Provide the date and class start and end time of the shift you have (or wish to) work. Include as much detail as possible. (e.g. Tuesday, April 12, 2A - 2:25 pm - 4:15 pm)

Instructor Name *
Instructor Name

Which acceptable reason do you have for requesting an exemption: *
Which acceptable reason do you have for requesting an exemption:

Course Name *
Course Name

Any other information you wish to provide. *
Any other information you wish to provide.