Application for Leave of Absence
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Student Name *

 
Please input your phone number *

 
Please choose your class location *


 
What is your current class day and time? *

for e.g. Saturday 4PM
 
Please let us know the reason for being absent *

 
You will not be available from? *

 
You will be available again on? *

Thank you, we'll get back to you within 3 working days!
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