ORU Student Development Chapel Excuse Form

Today's Date Today's Date / MM / DD YYYY
Name Name First Last
Z#
Must be 9 characters. Currently Entered: 0 characters.
(Include a capital Z)
ORU E-mail
Cell Phone Cell Phone - ### - ### ####
Residence Hall

Residence Hall Claudius EMR Frances Gabrielle Michael Niko Men's Wing Niko Women's Wing Susie Susie North Commuter**
Room Number
Must be between 3 and 4 digits. Currently Entered: 0 digits.
Classification
Local Address (if Commuter)** Local Address (if Commuter)**
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Type of Absence

Type of Absence One Time Multiple
Single Chapel Absence

If you missed one chapel due to illness or another documented reason, please complete the top part of this form and submit the supporting documentation below
Date of Chapel Absence Date of Chapel Absence / MM / DD YYYY
Long-Term Chapel Excuse

If you need to be excused from a chapel service on a consistent basis due to work or another obligation, please complete the following information. You must submit the appropriate documentation in order to be considered.
Chapel Days to be Excused

Chapel Days to be Excused Wednesday Friday
Dates to be Excused (please enter the dates you need to be excused using mm/dd format)
Reason for requesting chapel excuse.
Please upload any supporting documentation

Attach Files

You'll need to provide proper documentation in order to submit the Chapel excuse form
NOTE: ALL EXCUSES MUST BE VERIFIED BY LETTERHEAD FROM YOUR EMPLOYER, DOCTOR'S OFFICE OR OTHER APPOINTMENTS, PLEASE BE SPECIFIC. ALL PORTIONS OF THIS FORM MUST BE COMPLETED (INCLUDING UPLOADED DOCUMENTATION) AND SUBMITTED WITHIN 48 HOURS OF THE MISSED CHAPEL
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Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY
Type the letters you see in the image below.

ORU Student Development Chapel Excuse Form

Single Chapel Absence

Long-Term Chapel Excuse