Symposium Excused Absence Request Form

Attendance to the Annual Recruitment & Retention Symposium is mandatory per the promissory note that you signed to receive funding.  Failure to attend the symposium will cause permanent loss of your scholarship.  If you feel that you have a valid reason as to why you cannot attend, you may request an excused absence and submit documentation to support your request.  This is merely a request and it will be reviewed by the FFMT staff for approval or denial.  If denied, you are expected to attend and failure to attend will make you ineligible.  Upon completion of this request form, please be sure to email a copy of your documentation to cwilliams@ffmt.org or fax to (352) 846-3011.  Thank you.

Identification Information
Name *
Name
Phone *
Phone
Mailing Address *
Mailing Address
Institution
Reason for Absence