Request for Leave of Absence
__________________________________________________________________________________________
Name Student ID #
Classification: □ FR □ SO □ JR □ SR □ 2
nd
Degree □ Graduate
Policy:
A degree-seeking student who has a pre-determined need to leave Fontbonne for one or two semesters (not
including summer session) with the expectation to return, may request a leave of absence. The student with
an approved leave of absence may return under the same catalog and general education requirements in
effect at the time of the initial matriculation. If the student’s program curriculum has changed due to an
accrediting/approval agency mandate, the student must follow the new requirements.
Procedure:
The student must complete a Request for Leave of Absence form obtained from the Registrar’s Office by the
last day of the add/drop period.
Procedure to Return:
To re-enter Fontbonne, the student may go directly to the Registrar’s Office to request re-instatement and to
obtain registration materials, beginning at the time of early registration. The student must be advised and be
cleared by the advisor in order to register.
Reason for leave of absence: __________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Semesters for which leave of absence is requested: _______________________________________________
Please obtain signatures in the following order:
___________________________________________________________ ______________________________
Student Signature Date
___________________________________________________________ ______________________________
Advisor Signature Date
___________________________________________________________ ______________________________
Department Chair Date
___________________________________________________________ ______________________________
Student Services Center Signature Date
___________________________________________________________ ______________________________
Registrar’s Office Date
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