Leave of Absence and Vacation Request

Students requesting a Leave of Absence or Vacation are required to submit written notice prior to the start of the absence period in all cases; however, some exceptions may be made in emergency situations. Students may submit a Leave of Absence and Vacation Request Form and should give adequate notice when submitting. All requests must be approved by the Admissions Director or PDSO.

Name*

First NameLast Name

Program you are enrolled in:

Career Business EnglishPremium ESL 24Premium TOEFL 32

E-mail

Date*

Date

Vacation Session Dates

October 21, 2024 – December 15, 2024

January 6, 2025 – March 2, 2025

The dates you are requesting your absence: Please choose a session from the list above.*

Are you an F-1 student visa holder?*

YesNo

Are you requesting an eight-week vacation?*

YesNo

If you answered NO, are you leaving the country to take a Leave of Absence?*

YesNo

Write a detailed reason for your leave of absence and attach proof:*

Acknowledgement: I understand that failure to return to my studies after the agreed-upon end-date of my vacation or leave of absence will result in withdrawal/termination from the program and termination of my F-1 status if applicable. I agree to follow the rules/procedures of the Annual Vacation Policy and Leave of Absence Policy contained in my Student Handbook. I understand that being absent for (7-Weekend) or (9-Morning/Evening) consecutive school days when I am scheduled to return to school will result in termination. I agree and understand that by going on vacation, I may need to change my schedule and/or take an Exit Test so I can be placed in the correct academic level upon my return from vacation. I also agree to meet with a Student Advisor to discuss my vacation before approval or denial of said vacation.

When you go on vacation, we have to register you for the next session, so in order to your approve your vacation, we ask you to return to BIA and study for at least 1 session after your vacation.

Student Signature*

Admissions Director/PDSO Signature only