LEAVE OF ABSENCE
To be submitted by student
Mr. Ms.
(check one) Last (family/legal) Name First (
given) Name Middle name or initial
Address:
State, City, Zip Code:
SS # or ID # Degree/Certificate Program:
Telephone: Day:
E-Mail address:
I request a leave of absence:
Trime
ster absence begins: Fall Spring Summer Year
Trimester attendance resumes: Fall Spring Summer Year
The reason for this request (attach additional sheets if necessary):
_________
Students Signature:
Date:
Submit this petition to:
Office Location: Mailing Address:
Student Services Center Golden Gate University
Office of Records and Registration Office of Records and Registration
40 Jesse Street, 2
nd
Floor 536 Mission Street
Customer Service Reception San Francisco, CA 94105 (415) 442-7200
You may also fax form to (415) 442-7223, or scan and e-mail to re
cords@ggu.edu.
FOR GOLDEN GATE UNIVERSITY USE ONLY:
Evaluator’ comments:
ASA staff approval: _________ Date:
Dean/program director’s decision: APPROVED DENIED OTHER
Dean/program director’s signature: Date:
Revised 09/05/2008 Office of Records and Registration
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Leave of Absence Definitions
LEAVE OF ABSENCE
Student
s who have circumstances that require them to be absent from Golden Gate University (GGU) for 3 or more consecutive
trimesters (for a maximum of 6 trimesters) may file for a leave of absence. This will allow the student to return to GGU under his or
her original degree requirements. Students who do not return to GGU for the trimester specified are considered to have withdrawn
from the university and must apply for readmission under degree requirements in effect at the time of their readmission.
To qualify for a Leave of Absence, a student must be in good academic standing and have successfully completed at least one course
in degree status at GGU during the trimester immediately prior to taking leave.
International students MUST notify their Admissions and Student Affairs advisor PRIOR to beginning their leave.
A Leave of Absence is granted only once during a student’s entire academic program at GGU, will not be extended or approved
retroactively, and does not release a student from any pending financial obligations to GGU.
A written response to this petition will be sent to the student’s current e-mail address within 20 working days of the receipt of the
petition.
Submit this petition to:
Mailing Address:
Golden Gate University
The Office of Records and Registration
536 Mission Street
San Francisco, CA 94105
415-442-7200
Office Location:
Student Services Center
40 Jessie Street, 2
nd
Floor
Customer Service Reception
You may also fax form to (415) 442-7223,
or scan and e-mail to re
cords@ggu.edu.
Revised 09/05/2008 Office of Records and Registration