Please submit this form prior to the meeting you will be missing or from which you will be departing early.  No abscence or early departure will be excused without this form.  

Submitting this form does not guarentee that you will be excused. The USGA President holds the right to deny any request.

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Name: *
Phone Number: *
E-mail: *
Club/Organization Name: *
Position: *	Primary Represenative Back-up Represenative Senator USGA Executive Board
Absence or Early Departure: *	Absence Early Departure Late Arrivial
Reason for Absence/Early Departure: *
Date of Meeting: *
* = required field

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