Office of Graduate Studies
Application for Leave of Absence & Withdrawal
_______________________ _______________________
_______________________ _______________________
_______________________
ADDITIONAL STUDENT INFORMATION
Classification:
A.
Departmen
t/School:
Degree Program:Student ID:
First Name:Last Name:
FullTime
I currently hold the following award(s):
PartTime
NSERC SSHRC CIHR QE2GSST OGS IPS OGF
TO BE COMPLETED IF YOU ARE REQUESTING A LEAVE OF ABSENCE
While on leave of absence you may not function as a graduate student, including all research/writing activity and completion of
any incomplete courses, and may not make use of University resources, either personnel or physical in connection with your
graduate program. You are expected to check your university e-mail account on a regular basis for important notices.
B.
OTS
Leave of absence requests which exceed three consecutive semesters in length are not normally permitted. If you are requesting
more than three consecutive semesters leave, supporting documentation and a letter from your Advisor and/or Graduate
Coordinator must be submitted along with the application. The request will be reviewed by the Admissions & Progress Committee
of the Board of Graduate Studies.
Note: If you have registered for the semester in which you would like to take a leave of absence, you must also complete Section C
in order to withdraw from the current semester.
Are you currently on leave of absence? Yes
If Yes, then specify the previous consecutive semesters: ________
No
Number of semesters requested: __ _______ START: _____ _____ END: _____ _____
C. TO BE COMPLETED IF YOU ARE WITHDRAWING
Reason
for requested leave (Required):
MM/DDYYMM/DDYY
I wish to PERMANENTLY WITHDRAW from my graduate program. I understand that withdrawal does not prevent me from
applying for readmission in the future. (First semester students, see Withdrawal Policies on following page)
I wish to TEMPORARILY WITHDRAW from my graduate program, I am currently registered and have also completed Section B
requesting a leave absence from my program.
Reason for permanent withdrawal:
D. STUDENT AUTHORIZATION
I acknowledge that I have read and understand the information contained in the application for withdrawal/leave of absence.
Student Signature: ___________________________________ Date: _____________
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E. DEPARTMENT/SCHOOL use only:
______________________________________ ______
______Student ID Number:Student Name:
Specify stage at which student’s program is being discontinued (e.g. coursework completed, research partly completed, etc.):
Permanent Withdrawal
Leave of Absence
We support the request for leave of absence and guarantee that a place will be available to the student when s/he returns at the end of
the time indicated.
______________________________Advisor’s Name: ________________________________
_________________________________________ _____________
_______________________ ______________ _____________
Note: In the case where the Graduate Coordinator is the faculty advisor, the Chair or his/her designate must sign.
F. OFFICE OF GRADUATE STUDIES use only
Semesters of Absence: _________
__________________
__________________________________ Expected Return:
Date:Coordinator
s Signature:
Date:Advisor’s Signature:
Graduate Coordinator’s Name:
Approved
___________________________________ _____________Date:Signature:
Not Approved
Withdrawal Policies
A student who wishes to withdraw from the university is expected to consult with the department graduate coordinator prior to submitting the
withdrawal notice to the Office of Graduate Studies. Upon the authorization of the Office of Graduate Studies a graduate student who withdraws
from the university may be eligible for a refund of part of the fees, to be effective as of the date upon which the withdrawal notice is received in the
Office of Graduate Studies.
Tuition & Other Fees (Permanent/Temporary Withdrawal):
Refunds of tuition fees will be calculated according to the effective date and schedule. Refunds of University Non-Academic fees and Student Organization
fees (except Bus Pass, medical insurance premium and dental insurance premium) will be made in full up to and including the 15th class day of a semester.
No refund of University Non-Academic fees and Student Organization fees will be made after the 15th class day. Room charges will be refunded on a pro
rata basis for the period in residence, but cancellation of the residence contract will also result in forfeiture of all or part of the residence deposit. Refer to
the Residence Contract Terms and Conditions for further information. If the withdrawal results in a credit balance in your fees account, i.e. payments are
greater than charges, a refund cheque is produced. Allow approximately four weeks before refunds are available from Student Financial Services. The
University has been directed by the Ministry of Training, Colleges and Universities (MTCU) to return refunds to the National Student Loan Centre in
instances where assistance was received through a Government Student Loan.
Library: A student who withdraws from the University must return all outstanding loans from the Library immediately upon withdrawal, regardless
of the original due date. Any items not returned will be declared “lost" and charged to the student's account.
First Semester Students: A withdrawal for any student in the first semester of study will be permanent. If the student wishes to re-activate the
application file for a future semester, it must be done through their academic department/school. A new application fee will be required; a decision
form will be required from the department/school before a new offer of admission will be issued.
Re-admission: A student who permanently withdraws and who subsequently wishes to apply for re-admission to continue in the same program
will be assessed a re-admission fee. Contact the Office of Graduate Studies for the appropriate form. This re-admission process applies to any
student whose file has been closed by the Office of Graduate Studies because of unauthorized absence. Each department/school sets its own
guidelines regarding granting of credit for courses/research already completed for any withdrawn students who subsequently apply for re-
admission. Upon readmission, tuition fees will be at the rate set for incoming (new) students.
Protection of Privacy: We are committed to protecting your privacy. Personal information is collected under the authority of the University of
Guelph Act and pursuant to the Freedom of Information and Protection of Privacy Act (FIPPA). If you have questions about the use and
disclosure of your personal information, call the Office of Graduate Studies at (519) 824-4120 ext. 56833. You can also find more information
about access to information and protection of privacy at the University of Guelph from the University Secretariat.
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