Nevada Promise Leave of Absence

Name:*

First NameLast Name

NSHE ID:*

Phone Number:*

Please enter a valid phone number.Format: 000-000-0000.

Email:*

example@example.com

YesNo

Requesting a Leave of Absence for the Following Semesters:*

Please be specific. Example: Spring 2026 and Fall 2026

Semester You Plan to Return:*

An illness or serious medical problem of the student or a member of the student’s immediate family.Extreme financial hardship for the student or a member of the student’s immediate family.Engaging in any activity required or encouraged for members of the student’s religious faith.Mobilization of the student's unit of Armed Forces of the United States or National Guard.Other extraordinary circumstances beyond the control of the student that would create a substantial hardship for the student, as determined by TMCC.

Provide Details Regarding Your NPLOA Request:*

Upload Documentation:

Documents submitted must support one of the reasons listed above. Additional documentation may be requested at a later time.

Certification and Acknowledgment

By submitting this form, I certify that the information contained within this request, including all attachments and enclosures, is accurate and truthful. I understand this information may be shared with members of TMCC and the Nevada System of Higher Education, and as part of my permanent student file, may be reviewed by TMCC employees, their agents, or others contracted by TMCC to evaluate the administration of the Nevada Promise Program.

Please verify that you are human:*

Sender Name: