PETITION FOR LEAVE OF ABSENCE
NAME: NAU ID:
NAU EMAIL: PRIMARY PHONE:
DEGREE/PROGRAM:
ADVISOR/FACULTY MENTOR:
Leave of Absence requests must be filed no later than the deadline for adding a class during the semester in which
the leave is to start. A Leave of Absence cannot be granted retroactively. Student on an approved Leave of Absence
will not be required to apply for readmission. Students who are absent beyond the end of an approved Leave of
Absence may be required to apply for readmission as a graduate student and to the appropriate academic
department. A Leave of Absence will be extended beyond a year only under exceptional circumstances, and such
an extension must be requested on this form.
Please refer to the Continuous Enrollment, Graduate Policy
for additional information.
Requested Term/Year Leave Begins: Requested Term/Year Returning to Program:
PLEASE SUPPLY THE FOLLOWING:
Brief Statement of Request and a justification for requesting a leave of absence within the body of an email or on a
separate, attached document.
* INTERNATIONAL STUDENTS: You may have to complete additional processes to gain approval for a leave of
absence due to your visa status. Please contact the Center for International Education
for additional information on
this process.
Leave of Absence Recommended:
☐Yes ☐No Advisor Signature: D
ate:
☐Yes ☐No Ch
air Signature: D
ate:
Please submit the completed form to gradsuccess@nau.edu or NAU Box 4125.
Graduate College Use Only:
☐Yes ☐No Associate Dean Si
gnature: Date:
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