UNDERGRADUATE PLANNED EDUCATIONAL LEAVE REQUEST
California State University, Chico
Office of the Registrar
Chico, California 95929-0720
Fax: (530) 898-4359 Email: firstname.lastname@example.org
Eligibility for a Planned Educational Leave (PEL)
Undergraduate students or students seeking a 2 degree in good academic standing at CSU, Chico and in attendance as a
regular student beyond the fourth week of the previous semester are eligible to request a leave. Students that have applied
for a graduation term during the requested leave will be withdrawn from graduation or must reapply for a graduation term for
the requested semester of return marked below or a later semester.
Approval of your leave request grants you the right to continue under the catalog rights in effect at the time you left the
university. Upon your return from an approved leave you will not be required to complete a university admissions application.
A leave may be granted for a maximum of two consecutive semesters excluding summer. Under limited educational
circumstances, a leave may be extended for up to two additional semesters for a maximum leave of 2 years in accordance
with Title 5 regulations in order to maintain your catalog rights. If you do not return for your approved term, you will lose
eligibility to enroll, your catalog rights, and will need to apply for admission when you wish to return to CSU, Chico. All
requests are subject to approval and do not guarantee re-enrollment in impacted programs.
Request must be received in the Office of the Registrar no later than the Friday of the fourth week of the semester of
absence. All classes for the current and future semesters must be dropped before this request can be approved.
The following Student Groups must notify the offices below before submitting this request:
International students: Office of International Education, SSC 440, (530) 898-5415.
Financial Aid recipients: Financial Aid & Scholarship Office, SSC 250, (530) 898-6451.
Educational Opportunity Program students: Educational Opportunity Program, SSC 310, (530) 898-6831.
University Housing & Food Service resident students: If you reside in a University Housing community (i.e., a
residence hall or University Village) you must contact your building Residential Life staff to be checked out of your
room and to return all keys issued to you prior to your departure. Failure to do so will result in additional University
Housing fees as stipulated in the License Agreement. (530) 898-6325
Request a new Planned Educational Leave
Change semester of return on existing Planned Educational Leave
Semester last enrolled at CSU, Chico: FALL 20_____ SPRING 20____ SUMMER 20____
Semester of return to CSU, Chico: FALL 20_____ SPRING 20____ SUMMER 20____
You are responsible for dropping your classes.
Any fee and tuition charges on your account will be adjusted per the Student Financial Services Refund Policy.
Reason you are requesting a leave of absence: Medical Transfer Other
Student Name (Print) CSU, Chico ID Number Phone Number during leave
Student Signature Date
All communication regarding the status of this request will be sent to your CSU, Chico email account.
OFFICE USE ONLY: