Leave of Absence Request

Leave of Absence Request form

A Leave of Absence is an official period of time during which a matriculating student is not currently enrolled. A student may request that a leave of absence start during a semester in which a student is currently enrolled, or start with the next semester on the academic calendar. In the event that a student starts a leave of absence during a semester, all courses on the student’s transcript for that term will be assigned grades of “W” to indicate a withdrawal from those courses if the leave begins after the drop period. The transcript will also indicate “Leave of Absence” for the term in which the grades of “W” appear. A leave of absence, including extensions, is not given for more than one year. To request an extension of an approved leave of absence, students submit the “Leave of Absence Extension” form to the Office of the Registrar prior to the termination date of the approved leave. For a Leave of Absence to be official, this completed form needs to be submitted to the Registrar’s Office, Professional Center 15-3, or registrar@johnson.edu.

Student Name(Required)

First Last

ID:(Required)

Program:(Required)

Date leave will begin:(Required)

OR Semester leave will begin:

Indented return year:(Required)

Indented return semester:(Required)

Fall

Spring

Summer

Current Address:(Required)

Street Address Address Line 2 City State ZIP Code

Phone:

Mobile:

Personal (non-Johnson.edu) email:(Required)

Reason for Leave:(Required)

Graduation requirements in effect for students at the time their approved leave begins will remain in effect when they return from their leave under the following conditions:

They are in good academic and social standing at the College and have consulted with their academic adviser or program coordinator when their leave begins.
Their leave is limited to one year but may be renewed with the approval of the Registrar.
They maintain current contact information with the Registrar’s Office throughout the time of the leave.
They keep their advisor aware of their plans to return or to withdraw from Johnson College.
They understand that this policy does not bind the College to offer their curricula or major programs, which may have been discontinued or substantially altered during their leave of absence.

A student who is on a leave of absence will be considered by any loan lender to be not enrolled in school and will receive notices regarding repayment on any loans. Further, students who begin a leave during a semester should consult the refund policy and discuss their financial obligations with the Student Financial Services Office (Professional Center, 15-2) or be emailing Financialaid@johnson.edu.

A student who does not enroll by the end of the leave of absence is considered to have voluntarily withdrawn from the College. In that case, formal request for readmission must be submitted to the Enrollment department.

Signature

Date