Attachments

UNIVERSITY OF SUNDERLAND

 

NOTICE OF A LEAVE OF ABSENCE

 

STUDENT’S FULL  NAME:            …………………………………………………………………………………………

 

STUDENT’S REGISTRATION NUMBER: ………………………………………… DEPARTMENT: …………………………

 

START DATE OF PROGRAMME:  DD/MM/YYYYREGISTRATION EXPIRY DATE:  DD/MM/YYYY

 

LAST DATE OF ATTENDANCE**:   DD/MM/YYYYAGREED RETURN DATE:DD/MM/YYYY

 

PERIOD REQUESTED:From:  dd/mm/yyyyTo:  dd/mm/yyyy

 

REASON FOR THE LEAVE OF ABSENCE (INCLUDE ANY EXTENUATING CIRCUMSTANCES):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IF ON MEDICAL GROUNDS, HAS EVIDENCE BEEN PROVIDED:                  YES / NO

 

FEE STATUS:  HOME/EU/OVERSEAS/DISTANCE*

*PLEASE SELECT YOUR FEE STATUS

 

 

ARE YOU LIVING IN UNIVERSITY ACCOMMODATION?                               If yes, please complete this section.

 

ROOM/ FLAT: ……………………………………………………………. HALL/HOUSE: ……………………………………………

 

DATE YOU PLAN TO LEAVE THE HALL/HOUSE: ……………………………………………………………………………………………………………………

 

If, on vacating the premises, you fail to hand in your keys to the Hall Manager or security officer (Halls) or the Residential Service Officer (University Houses), the locks will be changed and you will be charged accordingly.

 

STUDENT HAS BEEN ADVISED BY DIRECTOR OF STUDIES TO CONTACT:

FINANCE CREDIT CONTROL (TEL: 515 3717)  

FINANCIAL COUNSELLING (If required) (TEL: 515 3478)

GRADUATE RESEARCH SUPPORT OFFICE  (5152072)

 

I agree with this request for leave of absence:

 

NAME OF DIRECTOR OF STUDIES:  .................................................

 

 

DATE: ….............................

 

NAME OF STUDENT: ……………………………………………………………………. DATE: ……..……………………….

 

**It is crucial that the last date of attendance is accurate. This affects the amount of tuition fee due, if applicable.

 

NB. You must complete a Return to Study Form upon your return to university.  The form will be provided to you by the Graduate Research Support office

 

International Students ONLY

International students MUST meet one of the International Student Advisers at The Gateway, City Campus to discuss the immigration implications for leave of absence.

Flight tickets/booking confirmation seen  Y /N

                                                                                  Information attached                                     Y/ N

SIGNATURE OF INTERNATIONAL STUDENT ADVISER:

 

……………………………………………………………………………………………………….

 

Please return this form to Graduate Research Support

For Official Use Only:

      Actioned in SITS   End Date Amended           

 

Date: …………………….                                                                                   

             Copied to Accommodation

 

LOAB 2012-3 v1.doc