Fillable Leave-of-absence-sgshs-06032014 SCHOOL OF GRADUATE STUDIES IN THE HEALTH SCIENCES

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Leave-of-absence-sgshs-06032014 SCHOOL OF GRADUATE STUDIES IN THE HEALTH SCIENCES

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SCHOOL OF GRADUATE STUDIES IN THE HEALTH SCIENCES
Leave of Absence Form
Student’s Full Legal Name:
Student Number:
Program/Year:
Effective Withdrawal Date:
Last Date of Attendance:
Expected Return Date:
Reason for Withdrawal/LOA:
Decision:
Good academic standing, LOA granted for up to 12 months to pursue training at
another institution.
Good academic standing, one academic semester for personal, financial, or medical
reasons.
Probation, and/or research efforts/results unsatisfactory, discretion of the program
director and Dean of the School.
Counseled to withdraw.
Other
__________________________ __________________________
Student Signature Date
__________________________ __________________________
Program Director Date
__________________________ __________________________
Dean, SGSHS Date
Revised: 06/03/2014
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Leave-of-absence-sgshs-06032014 SCHOOL OF GRADUATE STUDIES IN THE HEALTH SCIENCES

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Completed 3 November 2019

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