Request to Return from a Leave of Absence

Return from a voluntary leave of absence is at the discretion of the college and program, and graduate funding is not guaranteed. Requests for spring-semester return must be made by October 1, and requests for fall-semester return must be made by March 1.

Fields marked with * are required.

Please visit the ISSO site for important information about a return from leave requirements for international students.

I am requesting to return from a leave of absence for:
My last semester in attendance was:

Student Signature: _____________________________________  Date: ___________

Approval of Plan

Registrar approval of academic plan: __________________________________     Date: _________________

Comments:

 

Final Decision on Return Request

Granted, effective ___________________, with _____________________ expected graduation term.
Granted with conditions, effective _____________, with _____________ expected graduation term.
Denied

Student Services: __________________________________     Date: _________________

Comments/Conditionals:

 

Office Use Only

Date Received:  _________________

PS Term History   PS Tuition Calculation  PS Program/Plan/Grad term  FileMaker 
Update Listserv   Copy to Student cc Department/Advisor  Scanned to Student Record
Date Processed: ____________________
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