2026 Leave of Absence (LOA) Request Form

Please note that submitting an application does not automatically constitute approval. Once your application has been processed, you will receive a separate notification email.

Current Campus*

Student Services Email

Name*

First NameMiddle NameLast Name

Student ID*

Program *

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Student Status?*

The reason for my request is:*

Other. Explain:*

*If you are traveling outside the U.S. during your annual vacation, please
speak with your DSO regarding your travel I-20

**If you are traveling outside the U.S. during your annual vacation, please
speak with your DSO regarding your travel I-20

***If you are requesting a Medical Leave of Absence (LOA), please
contact Student Services for guidance and required documentation

I request a leave of absence from

I will return on

Guidelines:

Students in good financial and academic standing may apply for an annual vacation for up to one semester (two consecutive eight-week sessions) per academic year.
An annual vacation does not adversely affect satisfactory progress toward a degree.
Students are encouraged to consult an academic advisor and the Student Financial Services Department before taking an annual vacation/a leave.
A leave of absence cannot be approved while a student is actively enrolled in the middle of a semester.
Application for an annual vacation must be made prior to the start of the session in which the vacation period is to begin. The vacation will NOT be granted for a session that has already started.
Failure to return at the end of an approved annual vacation results in the student being withdrawn from the University.
An international F-1 student is eligible for annual vacation if they have studied in the United States for eight (8) consecutive months. During annual vacation, a student can remain in the United States, or they can travel abroad. Annual vacations cannot exceed four (4) months. If traveling outside the U.S. during your break, please speak with your DSO regarding your travel I-20.

By checking the boxes below:*

I understand that if I have Stafford loans and do not return from an annualvacation/a leave, my loans may go into immediate repayment.I understand the annual vacation/leave of absence guidelines mentioned abovein accordance with the Academic Catalog.

***Students must be cleared by the Student Support Services Department***

Student Signature*

Date:*

Office Use Only

Printed Name/Signature

Student Services*: _________________________________ [ ] Approved [ ] Denied

Student Finance: __________________________________ [ ] Approved [ ] Denied

DSO (If applicable): _______________________________ [ ] Approved [ ] Denied

Registrar: ________________________________________ [ ] Approved [ ] Denied

GPA: _________

Comments:________________________________________