Saint John’s University Request for a Leave of Absence

Completion of this form and submission of a letter detailing the reasons you are seeking a Leave of Absence are necessary to insure consideration of a Leave of Absence from Saint John’s University. This completed form, your letter and any other documentation should be sent to Michael P. Connolly, Dean of Students, Saint John’s University, 210 Sexton Commons, Collegeville, MN, 56321 or faxed to (320) 363-3741. Today’s Date___________________ Current Information

Leave of Absence Request

Your request for a Leave of Absence will be reviewed by the Dean of Students and Academic Advising. You will be notified regarding the status of your request within 10 business days of the receipt of your request. Students who are approved for a Leave of Absence may be required to provide documentation verifying their ability to re-enroll in the institution. Re-enrollment information can be obtained by contacting Teri Durbin, Associate Director of Admission at (320) 363-5852 or tdurbin@csbsju.edu.

I am seeking a Leave of Absence from to . Date Date

My last date of class attendance was or will be . Date

I will be vacating my on-campus residence and checking out on . Date

Semester you are planning to return to SJU � Fall 20_______ � Spring 20_______ Student Signature Date

For your request to be considered, you must also submit a letter detailing the reasons for your request. If the Leave of Absence is requested for medical reasons, a letter from your care provider is also required.

Name ID # Last First Middle

On Campus Address PO Box Building Room #

Home Address

Street City State Zip

Do you have a loft or refrigerator rented in your name? � Yes (please check appropriate box(es) � No

� Loft � Refrigerator

Please Note: All mail and correspondence will be forwarded to your permanent home address. If your permanent home address has changed during your time as a student at SJU please go to the Registrar’s Office (located in the Quad to confirm that the correct permanent address is on record.

Internal Use Only

Dean of Students: � Approved � Denied Signature Date

Academic Advising: � Approved � Denied Signature Date

Leave of Absence begins: Leave of Absence ends: Anticipated semester of re-enrollment: Actual semester of re-enrollment:

Leave of Absence Policy

A leave of absence is most appropriate for a student who is temporarily discontinuing enrollment at CSB or SJU for a period of

time. Circumstances that may merit a leave of absence include medical situations or family emergencies. The Dean of Students

and Office of Academic Advising will determine whether a leave of absence is to be granted. The length of the leave shall be no

more than two semesters, one semester being the one in which a student was granted the leave. The proper leave of absence

form must be completed for the leave to be considered. Leave of absence forms are available at the Residential Life Office at St.

Benedict’s, the Campus Life Office at St. John’s, or the Academic Advising Office on either campus.

No official record of attendance for that term is kept if a student is granted a leave of absence from school during the first three

cycles of the semester. A student, who is granted a leave of absence from school after that date, but before the final 16 class days

of the semester, receives a grade of “W” for all courses registered for that semester. A leave of absence during the last 16 class

days of any semester will be considered on a case by case basis.

In the event of a withdrawal pursuant to this policy, the normal tuition refund schedule will apply. If a student withdraws

from school before completing 60% of a semester, the College or University may be required to return some or all of the

federal or state financial aid awarded to the student.

Students who take a leave of absence from Saint Benedict’s or St. John’s may choose to reenroll in order to continue their studies.

Consult the Admission Office for further information on reenrollment after a leave of absence.

Refund Schedule

Refunds are made according to the following schedule:

100% refund for students withdrawing before the first day of classes;

90% for withdrawing through the 5th day of classes;

80% from the 6th through 10th day;

70% from the 11th through 15th day;

60% from the 16th through 20th day;

50% from the 21st through 25th day; and

40% from the 26th through 30th day.

If a student withdraws after the 30th day of classes, there is no refund; however, refunds on food will be pro-rated based on the

time remaining in the food contract. The date used to calculate the refund will be: in the case of official withdrawal, the date of

withdrawal; in the case of unofficial withdrawal, the drop-out date which can be documented.

For more information about refunds and financial implications for a Leave of Absence, you may contact the SJU Student Accounts

Office at (320) 363-2193 and/or the Financial Aid Office at (320) 363-3664.

June 2010