UNDERGRADUATE/2nd BA LEAVE OF ABSENCE PETITION ?· Office of the University Registrar. UNDERGRADUATE/2.…

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<ul><li><p> Office of the University Registrar </p><p>UNDERGRADUATE/2nd BA LEAVE OF ABSENCE PETITION </p><p>1. Who is eligible? </p><p> Sacramento State undergraduate and second baccalaureate degree students who will not be enrolled at Sacramento State for more than one semester may file for a leave of absence to maintain enrollment eligibility and catalog rights to specified degree requirement options. </p><p>2. Who is not eligible? </p><p> Undergraduate or second baccalaureate students dismissed due to academic deficiencies or disciplinary actions are not eligible for leaves of absence. </p><p> Students enrolled only in extension courses or as auditors are not eligible for leaves of absence. Graduate students anticipating a leave of absence should visit the Office of Graduate Studies </p><p>website: http://www.csus.edu/gradstudies/CurrentStudents/forms.html. Sacramento State students studying abroad through independent programs should contact the Office of </p><p>Global Education for information. This leave of absence petition is NOT for students who will be taking courses at another accredited </p><p>college/university. Sacramento State students who will not be enrolled at Sacramento State for only one semester DO </p><p>NOT need to petition for a leave of absence. Students are granted an automatic leave of absence for one semester per University policy. </p><p>3. What if I need to file this petition in the middle of the semester? </p><p> Enrolled Sacramento State students requesting leaves during a semester must follow withdrawal procedures. All contractual agreements (housing, financial aid, etc.) must be satisfactorily terminated. </p><p>4. Types of Approved Leaves of Absence: </p><p>Medical A statement from a medical professional is required verifying the timeframe for the leave. Leaves for pregnancy are restricted to the semester of delivery and the one following. In the event a medical leave needs to be extended beyond the original approved leave, an additional leave </p><p>of absence petition and medical verification will be required. </p><p>Military A copy of military orders indicating duration of service is required. Eight semesters absence is the maximum which can be approved for military leaves. </p><p>Personal Students who, for personal reasons, are temporarily unable to continue their program of study may request </p><p>a leave of absence not to exceed two semesters. In the event a personal leave needs to be extended beyond the original approved leave, an additional leave </p><p>of absence petition with a statement of personal circumstances must be submitted. Four semesters absence is the maximum which can be approved for personal reasons. </p><p>Planned Educational This option is not for students who will be taking courses at another accredited college/university. Students may petition for planned educational leaves to pursue educationally related activities that will </p><p>enhance the prospect of successful completion of their academic programs. For example: an Anthropology major taking a year off to volunteer at an archeological dig site in Chile. </p><p> Department recommendation is required. A planned educational leave may be granted for up to two years. </p><p>http://www.csus.edu/gradstudies/CurrentStudents/forms.html</p></li><li><p>LEAVE OF ABSENCE CHECKLIST </p><p>Completed petition Reason for request should be a concise statement as to why you are requesting a leave For medical leaves: statement from medical professional including timeframe for leave For military leaves: a copy of your military orders indicating duration of service For personal leaves: statement of personal circumstances requiring </p><p>leave For planned educational leaves: major department faculty advisor or </p><p>department chair approval on petition </p><p>WHAT HAPPENS NEXT? </p><p>1. Submit completed form with verification to the Office of the University Registrar, Lassen 2000. </p><p>2. Notification of the leave of absence decision will be emailed to you for your records within approximately two weeks. </p><p>3. Students who do not return to Sacramento State at the conclusion of their planned leaves or those who are absent beyond the time limit are required to reapply for admission to the University. </p><p>4. As long as you are returning the semester indicated on your petition, you will automatically receive a registration appointment for that semester. Log in to your Student Center to find out your registration appointment by the end of April for Fall registration and by the end of November for Spring registration. </p><p>5. For general questions regarding leaves, please contact the Registrars Office at (916) 278-8088. </p></li><li><p> Office of the University Registrar </p><p>UNDERGRADUATE/2nd BA LEAVE OF ABSENCE PETITION </p><p> Last Name First Name M.I. Student ID Number (NOT SSN) </p><p> Street Address Apt # Telephone Number </p><p> City State Zip Major </p><p> Undergraduate 2nd Bachelors Email TYPE OF LEAVE LENGTH OF REQUESTED LEAVE </p><p> Medical Educational* Last Term Enrolled Year and Term of Return </p><p> Military Personal </p><p>*Department recommendation required (see below) REASON FOR REQUEST: This statement must be consistent with the Universitys Leave of Absence policy as stated on the cover sheet. Attach verification of all conditions as necessary. Please provide a clear, concise statement. </p><p> I have read and understand the instructions and policies regarding a Leave of Absence. Student Signature ___________________________________________________________________ Date _________________________ </p><p>FOR EDUCATIONAL LEAVES ONLY </p><p>Department Recommendation YES NO Faculty Advisor or Dept. Chair Signature ____________________________________________ Date _________________________ </p><p>RETURN COMPLETED AND SIGNED FORM TO THE OFFICE OF THE UNIVERSITY REGISTRAR, LASSEN 2000 </p><p>FOR OFFICE USE ONLY APPROVED DENIED By _____________________________________________________ Date _____________________________ </p><p>Comments _______________________________________________________________________________________ Date Posted _____________________________ </p><p> _______________________________________________________________________________________ Updated 12/11/13 </p><p>ryan.johnsonStamp</p><p>Last Name First Name M.I. Student ID Number (NOT SSN)Street Address Apt # Telephone NumberCity State Zip MajorUndergraduate 2PndP BachelorsEmailMedical Educational*Last Term Enrolled Year and Term of ReturnMilitary Personal*Department recommendation required (see below)</p><p>Check Box1: Check Box2: Check Box3: Check Box4: Check Box5: Check Box6: Text7: Text8: Text9: Text10: Text11: Text12: Text13: Text14: Text15: Text16: Text17: Text18: Check Box19: Check Box20: Text21: Text22: Check Box23: Check Box24: Check Box25: Check Box26: Text27: </p></li></ul>

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