SOUTH PUGET SOUND COMMUNITY COLLEGE
Student Absence for Faith or Conscience Form
Please Submit the Completed Form to the One Stop in Building 22.
INSTRUCTIONS TO COMPLETE THIS FORM – All information must be filled out completely for this form to be accepted and processed
Step 1. The requestor will fill in “SECTION – A” and “SECTION – B” then forward the request to the One Stop in Building 22 on the Olympia
Campus or Building 1 on the Lacey Campus.
Step 2. Enrollment Services will log the request for tracking.
Step 3. Enrollment Services will email the necessary instructor(s) of the excused absence(s).
Other Important Information:
• Only the requestor will be able to submit a request on their behalf.
• Student must submit request within the first two weeks of beginning the course, of the specific dates of the anticipated absence.
• The student is responsible for making arrangements with their instructor to make up missed assignments, quizzes, tests, and/or projects.
• The student is responsible for notifying the One Stop immediately if the day(s) are not taken due to any changes.
Requestor Name (Print Full Name):
Quarter
Summer ☐ Fall ☐ Winter ☐ Spring ☐
SECTION – B List All Courses and Instructor Name for Each Class That Will Be Missed on Date of Absence(s)
:
In accordance with RCW 28B.10.039, students are entitled to take excused absences for reasons of faith or conscience, or for organized activities conducted
under the auspices of a religious denomination, church, or religious organization. Students’ grades may not be adversely affected by absences authorized
under this policy. Students must notify the College in writing within two weeks of beginning the course in which they are requesting an absence under this
policy. The College shall make no judgment about the legitimacy of reasons of faith or conscience.
The requestor and/or department should retain a copy of the completed form for their records. South Puget Sound Community College does not discriminate
on the basis of color, race, national origin, sex, disability, sexual orientation or age in its programs and activities. Students who need disability
accommodations should contact Access Services in Bldg. 22, email access.services@spscc.edu or call 360-596-5306.
AFC Form (7/28/19)
