USCH Leave of Absence Application Form

Leave of Absence Application Form
Relevant Standards

SRTO 2025: 2.2, 2.4, 2.6, 2.7 and 2.8

The National Code 2018: Standard 2.1.8, 9

Linked Documents

Deferral, Suspension, and Cancellation of Enrolment Policy

Student Code of Conduct

Academic and General Misconduct Policy

Students Complaints and Appeals Policy

Withdrawal from Course Form
Name
Student ID
Contact Phone
Email
example@example.com
Course Group
NOTE: Your requested leave of absence MAY NOT EXCEED TWO CALENDAR WEEKS in a designated study period. If compassionate or compelling circumstances require you to take a longer leave, you must submit a Deferral and Allowable Suspension of Studies form.
Leave from

DayMonthYear
Date
To

DayMonthYear
Date
Total Number of Days
Reasons for taking Leave
Please provide as much details as possible. Note: Attach any supporting documents with this form as applicable
Signed

Clear
All the information I have provided in this form is true and accurate. I also understand that this leave of absence may impact upon my course progress.
Date

DayMonthYear
Date
File Upload

Cancelof
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