NLI Request for Absence Form

All requests for absence forms are due to the Executive Director no later than December 4, 2009.

First Name

Middle Name

Last Name

Chapter

University/College

Cell Phone

Phone Number

Holiday Address

City

State

Zip Code

I request to be excused from attending the I's Leadership Institute scheduled to take place January 8-10, 2010, for the following reasons:

Characters Entered=0 (Max 3000)

I understand that I am ineligible for the office of Number I if I have prior knowledge that I will be unavailable for the I's Leadership Institute. I also understand that if the Executive Director does not approve my absence, elections must take place to elect a new Number I that can attend the I's Leadership Institute.

Send a confirmation copy to me upon submission