EMERGENCY PASS for a Homework Assignment in EECS 206 W03


Student Name (Last, First) ____________________________________



UMID Number ___________________		Lab Section # __________



Homework # ____________________



Did you turn in this assignment (yes/no)? _____________



"I hereby request that the homework assignment listed above be excluded
from the calculation of my total HW percentage, i.e., my overall HW
percentage will be based on all other HW assignments.
I recognize that this will be my one and only excused homework
for the entire semester and I will make no further such requests."



Signature ________________________________  Date ____________



(You may submit this form even if you handed in the HW.)

This form must be submitted to your GSI within 6 days of the
official due date/time of the HW assignment.