Faith & Conscience Leave Request - LOWER COLUMBIA COLLEGE

Faith & Conscience Leave Request Form

Lower Columbia College
Student Name
Email
example@example.com
SID
Quarter
Year
Dates Requested for Faith & Conscience Leave
Explanation of how the requested holiday is related to a reason of faith or conscience or an organized activity conducted under the auspices of a religious denomination church or religious organization
Requests must be within the first two weeks of the course to be eligible under the Faith and Conscience Leave policy, please upload a copy of your schedule to this form.
File Upload

Cancelof
Student Signature

Clear
Today's Date

MonthDayYear
Date
Below - OFFICE USE ONLY
Date

MonthDayYear
Date
Faculty Name
Date

MonthDayYear
Date
Faculty Name
Date

MonthDayYear
Date
Faculty Name
Date

MonthDayYear
Date
Faculty Name
Date

MonthDayYear
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Faculty Name
Date

MonthDayYear
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Posted to Faith Conscience Leave Spreadsheet
Should be Empty:

Faith & Conscience Leave Request Form