Fillable University of West Georgia - ED.D. in Professional Counseling and Supervision Request for Leave

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University of West Georgia - ED.D. in Professional Counseling and Supervision Request for Leave

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1
ED.D. IN PROFESSIONAL COUNSELING &
SUPERVISION
Request for Leave
Name Date of this request 917
I hereby request a leave from the Professional Counseling & Supervision program at the
University of West Georgia for the following reason:
I accept the responsibility for submitting in writing a request for a readmission interview with the
Program Director in order to determine my readiness for readmission to the program. This
request must be made by at least 60 days prior to semester of proposed reentry.
I understand that I must be in academic and professional good standing at the time of my request
and that I will be assigned to the next available cohort on a space available basis.
Approved Denied
Student Signature Date
Program Director Signature Date
Enter Reason Here
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University of West Georgia - ED.D. in Professional Counseling and Supervision Request for Leave

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Completed 27 May 2020

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