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B Not suspension eligible will be counted toward maximum allowed days away from the clinic. LOAN REPAYMENT RECIPIENT Name Site s Email Phone Number DETAILS REGARDING DAYS AWAY FROM APPROVED SITE Quarter s 2017 Jan Mar Dates away from the site Apr Jun Jul Sep to Oct Dec Dates estimated Exact End date unknown at this time Number of workdays away from the site Reason for request Note WSAC may request supplemental information/documentation as needed. FMLA Medical leave Active military service...

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