CENTRE FOR FOUNDATION STUDIES (KAMPAR CAMPUS)

Form Title : PERMISSION FOR CLASS REPLACEMENT

Form Number : FM-CFS-KPR-05
Rev No: 0
Effective Date: 26/05/2016
STUDENT DETAILS

Page No: 1 of 1

* To be filled by student

Name*
Student
ID*
CLASS REPLACEMENT HISTORY (Tick [ ] the necessary options and write your reason)
Contact no*

First replacement for this course*

Reason*

Second replacement for this course*

Reason*

Note: Class replacement is not allowed for more than twice.

CLASS REPLACEMENT DETAILS
* To be filled by student
** Delete whichever not applicable
Course*
Original Class
Replacement Class
Lecturers Name*
Class *
Lecture ( ) / Tutorial ( ) / Practical ( ) **
Lecture ( ) / Tutorial ( ) / Practical ( ) **
Date*
Time*
Remarks by
lecturer (if any)
Lecturers
Signature

STUDENT DECLARATION (To be read carefully and completed by student)

DECLARATION
I hereby apply to be granted a Replacement Class for the above mentioned course. I understand that this form
must be approved & signed by the original lecturer first before and not after the replacement class (even for
cases where original and replacement classes are conducted by the same lecturer).
I agree that this form is to be submitted to the original lecturer within THREE (3) working days by the student
after the replacement class. Any late submission shall not be entertained.
I understand that I attend this replacement for knowledge purpose and not solely for attendance.
I understand that my original lecturer reserves the right to mark me as absent since I actually did not attend
his/her class. I acknowledge that granting of Replacement Class attendance is NOT AUTOMATIC OR
COMPULSORY but at the absolute discretion of my lecturer.
I declare I understand and agree to all the conditions mentioned above.

_______________________
Students signature
Date: