Completing the Leave of Absence Form
The following information will help you to complete the leave of absence form
Read the form and understand what you are signing. Contact us, if you have questions.
We are unable to process incomplete forms. It is your responsibility to be sure that the form is complete and is received.
Instructions
- The form is a fillable pdf. If you have technical difficulties, print out the form and fill in ALL information.
- Effective Date is the date that the actual leave starts.
- If the leave is taken in the same semester, the effective date must be your last day of attendance in your classes.
- If the leave is taken for the next semester, use the first day of classes of the next semester for your Effective Date.
- Return Date can be left blank. We will enter the last day of the leave semester
- Select your reason for the leave and briefly describe the reason for this request.
- Include your Full name and ID where indicated.
- Obtain ALL applicable signitures before submitting this form.
- Educational Opportunity Participant - If you are an EOP student, meet with your advisor and have the form signed to confirm that you have been advised about the leave
- On-campus resident student -If you live on campus during the current or next semester, the Director of Residence Life must review and sign off on the leave
- International Student - If you are international, a leave may impact your visa status. Your International advisor must review and sign off on the leave
- Student Accounts- All student leaves must be reviewed by Student Accounts to determine if there is financial liability or financial aid adjustments.
- Sign and date form - We are only able to accept signed and dated forms.
You must always sign the form, without exception. We can make an exception to obtaining applicable signatures (#6), if you are no longer on campus and will not be returning. In those limited cases, we will accept an email from the applicable offices to acknowledge that you have been advised. Please contact us to be sure that an email acknowledgement from these offices is acceptable.
