Leave of Absence


Student Name & Address:



I am requesting a Leave of Absence (LOA) for the following reasons;

LOA Guidelines: LOA REQUEST is only allowed for 01 semester and may be extendable upon second request for an additional semester for maximum of 01 academic year (02 semesters). ALL REQUESTS must be made 25 business days in advance for consideration. STUDENT requesting LOA are required to be in good academic and financial standing with the University. STUDENT in pre-clinical and clinical levels are required to complete the semester before leaving on absence. LOA requested for during a semester session may result in a Withdrawal (W) grade for all courses registered. STUDENT'S taking a leave without notification or LOA approval or does not return within the time allowed may face dismissal and would have to re-apply for admissions. STUDENT'S are required to pre-approve LOA request from his / her department head / Dean for submission to the Registrar's Department for final approval.

I hereby agree to the terms & conditions per GMU policy.Date: 01/23/2018

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