Name: 

Office:  

County:

Region:

Event for which you would like to be excused:

Face-to-Face Meeting
Meeting Date:

Conference Call
Conference Call Date:

Other
Please Explain:

Please explain your reasons for requesting an excused absence:

I understand that if this request is granted, this absence will not count against me for the fulfillments of my meeting requirements. However, I am also aware that if not granted, or if I do not turn this in on time, I will be unexcused, and the absence will count against fulfilling my meeting requirements.

I have read the above statement and understand.
I have read the above statement and do not understand.