Petition for Exemption from Mandatory Attendance Event

Role

1. Are you requesting an exemption from a pre-clerkship, clerkship course, SubI or elective course? *This question is required.

Student information *This question is required.

Student First Name *This question is required.

Student Last Name *This question is required.

Student Email Address *This question is required. This question requires a valid email address.

2. Administrator/Instructor/Coordinator Information *This question is required.

Your First Name

Your Last Name

Your Email Address

2. Date of mandatory attendance event: This question requires a valid date format of MM/DD/YYYY.

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