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Leave of Absence (LOA) Request form

Purpose A Leave of Absence (LOA) lets you take a temporary break from your studies without being marked as withdrawn.

Full name

Email

Program

Cohort

Date of request

Leave Start Date

Expected Return Date

Total Length of Leave (days)

Reason for Leave (check one and add more details if you'd like)

Please share a short explanation to help us review your request (You don’t need to share personal or medical details if you prefer not to.)

Please attach supporting documentation (if applicable)

Acknowledgment

By signing below, I understand that:

- My LOA request will be reviewed and is **not automatically approved**.

- If approved, I won’t be charged any extra tuition or fees during my leave.

Signature

Untitled checkboxes field

I understand that if I don’t return by the approved date, I’ll be considered **withdrawn** as of my last day of attendance, and my financial aid might be adjusted (R2T4)

A leave of absence means I’m temporarily separated from the college, not an active student, and won’t have access to courses or be expected to complete any coursework during my leave.

I understand that I can return before my LOA end date if I coordinate with the School Director, that any extension must be requested and approved in advance, and that if I don’t return by the end date I may be dropped and must re-enter the program; I also understand that I need to check in with Financial Aid on the day I return.