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Student Declaration Absence Form

The Student Declaration of Absence form allows students at Dalhousie University to report short-term absences from required classes, tests, or coursework due to health conditions or other circumstances. Students must notify their instructor and submit the form within three days of their absence, and it can only be used for absences of up to three consecutive days. The form has specific limitations and does not guarantee automatic exemptions from academic requirements.

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12 views1 page

Student Declaration Absence Form

The Student Declaration of Absence form allows students at Dalhousie University to report short-term absences from required classes, tests, or coursework due to health conditions or other circumstances. Students must notify their instructor and submit the form within three days of their absence, and it can only be used for absences of up to three consecutive days. The form has specific limitations and does not guarantee automatic exemptions from academic requirements.

Uploaded by

mz8htdjyqj
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

STUDENT DECLARATION OF ABSENCE

From required classes, test, exams or other coursework

TO BE COMPLETED BY THE STUDENT

Dalhousie University recognizes that you may experience short-term physical or mental health conditions, or other extenuating
circumstances that may affect your ability to attend required classes, tests, exams or submit other coursework.
You can use this form to report when you miss or are late for required class participation, tests, and exams, or other faculty, college or
school-specific program work. You may not use this form for final coursework or exams, fieldwork (including work-integrated
learning for credit), co-op work terms and internships, and skill labs.
You must review faculty, college, school, instructor-specific, or course-specific syllabi and guidelines, and work-integrated learning
handbook policies that explain your responsibilities, the consequences, and how you might compensate for missing or being late for
required class and coursework. If you have an accessibility plan that already allows for coursework deferrals or deadline
extensions, you do not need to submit this form.

If you experience a short-term absence that is no longer than 3 consecutive days you must:
• Notify your instructor by phone or email prior to the academic requirement deadline or scheduled time and;
• Submit this form to your instructor, or other authorized person, by email, on-line through Brightspace, or in-person within three
(3) days following your last day of absence.

Banner Number Your Name Course name, code and section

Bennett Intro to Accounting COMM1101 04


B00

Date (yyyy/mm/day) of missed or late academic requirement Type of missed or late academic requirement (i.e. class
attendance, exam, paper, etc.)

2025,11,05 Midterm

By signing this form, I agree that:


• I can only submit this form two times (or the number of times defined by my instructor) for each course during an academic
semester;
• I can only use this form for a short-term absence that is no longer than 3 consecutive days;
• this form does not provide me with an automatic exemption from any academic requirements that were missed or late during
my absence;
• any alternate coursework arrangements for missed or late academic requirements are at the discretion of my individual course
instructor(s);
• a record of this declaration will be kept on file and fall under the Freedom of Information and Protection of Privacy (FOIPOP);
• if I knowingly provide “false information and identification” with this declaration, I have committed academic dishonesty and am
subject to University discipline (per Section 7 of Dalhousie’s Code of Student Conduct).

Your Signature Today’s Date (yyyy/mm/dd)

2007/11/05

The Student Declaration of Absence form may be shared with other instructors, faculty members, and faculty administrators within a student’s faculty,
college or school to the extent that such disclosure is necessary to maximize support of students in successful completion of academic requirements.

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