Counseling Request for Leave of Absence

Student's Name: ______________________ Student No._________________ Date: ________

A candidate for the degree: Master’s Degree School: School of Education & Human

Development

Rules About Leaves of Absence

A student may take periodic leaves of absence from the Counseling program, as long as the total time to

the completion of the degree does not exceed seven years. Approved leaves of absence do not extend

the limit beyond a total of five years. A student may take up to two semesters of approved leave of

absence without having to apply for readmission to the program upon her/his return.

Faculty members are not obliged to meet with students on leave, and ordinarily students on leave will

not be able to use University facilities. However, it may be possible to pay certain fees to continue using

basic University facilities while on leave; consult the Registrar's Office for details.

Request for Leave of Absence

I started the Counseling program:

I intend to leave the program beginning:

I will resume the program:

Semester and Year

Reasons for requesting a leave of absence (use separate page if needed):

Student signature: ___________________________________________Date: _____________

Approvals

Student's faculty advisor: ______ Date: _____

Leader of the Counseling program: ____ Date: ____ _____

Submit a completed copy of this form to the Counseling program academic advisor in the

School of Education & Human Development Academic Services Center.