Leave of Absence Form

Leave of Absence Form
Request for Leave of Absence can be submitted through your online student portal via the "Student Online Systems". This form is only to be used when the online systems are closed.
Name*

First NameLast Name
Student ID Number*
Programme/Major*
Email*
Student email
Contact Number
Please enter a valid phone number.
I hereby apply for leave of absence for: (Specify semester and academic year)*
Comments from Student (Optional)
Registered for any Year-long Courses?*

YesNo
If Yes, please indicate course code
Signature of Student*

Clear
Date*

MonthDayYear
Date
Should be Empty: