Excuse Letter

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Republic of the Philippines

CAPIZ STATE UNIVERSITY


College of Management
Main Campus, Roxas City

Guidance and Counseling Office


_________________________
Date
__________________________________
Name of Instructor/Personnel
OR
To whom it may concern:

Greetings!

Please excuse me for having been absent from my ______________________________ class


last _____________________ because _________________________________.
I am hoping for your kind consideration regarding this matter.
Thank you.

Respectfully yours,
____________________________________
Signature over printed name

____________________________________
Course/Year/Section

Noted by:
_________________________________
Signature over printed name of Program Coordinator/Chair

Approved by:
_________________________________
Signature over printed name of Dean/Program chair

______________________________________________________________________________________________

FURTHER ACTION: This Certifies that the abovementioned student has


To be filled up by Dean / Program Chair
undergone initial interview/assessment/counseling at
the Guidance Office based on the referral made by
Refer student for counseling
the Dean/Program chair.
If necessary
(Forward letter to Guidance Counselor)

Guidance Counselor/Psychometrician

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