CENTRE FOR FOUNDATION STUDIES (PERAK CAMPUS)

Form Title : CLASS REPLACEMENT FORM Rev No: 0 Page No: 1

STUDENT’S DETAILS
Name Student ID
Gender* Male / Female Tel no
Name of Guardian Contact no
CLASS REPLACEMENT DETAILS
Type (eg: P20 or T4) Date
Actual class
Time (eg: 1500-1700) Tutor/Lecturer
Replacement Type (eg: P15 or T6) Date
class Time (eg: 1500-1700) Tutor/Lecturer
REASONS (Please provide detail explanation with at least 20 words)

CLASS REPLACEMENT HISTORY

Any previous application before this : Yes/No* (If yes, please provide details below)
Reasons
for previous
application
VERIFICATION BY ORIGINAL LECTURER
Name
Date/Time
Remarks
(if applicable) ______________
Signature
VERIFICATION BY LECTURER OF REPLACEMENT CLASS
Name
Date/Time
Remarks
(if applicable) ______________
Signature

Note: 1. This form must be approved & signed by the original lecturer first before the
commencement of the actual class and not after the replacement class. This form
is to be submitted to the original lecturer by the student after replacement class.
2. I understand that my original lecturer reserves the right to mark me as absent since
I actually didn’t attend his/her class.

____________________ ____________
Student’s Signature Date
Name: