Leave of Absence Request

Name

First Last

What is your student ID number?*

Which option below closest describes your ethnicity?*

White

Black

Asian

Mixed or another identity

Prefer not to say

Please tell us your mailing address during your leave.*

Please tell us your contact telephone number while you are on leave.*

Please tell us your personal email address during your leave.*

Please note that all University business including correspondence about registration, finance, immigration, etc will be sent to your University email address which will be available to you during your leave.

Are you studying on a visa?*

Please note that your visa will be reported to UK Visas and Immigration and will likely be curtailed. When you return to Richmond, you must enter on a new visa (even if your current visa appears to be valid). For more information about the re-application process, please contact Student Affairs at studentaffairs@richmond.ac.uk.

Yes

What is your reason for requesting a leave of absence?*

If you believe there are mitigating circumstances surrounding your request for a leave of absence that make you eligible for a financial exception to the University's payment policy, please contact Student Affairs to discuss your situation at studentaffairs@richmond.ac.uk

Medical

Personal

Family-related

Financial

Other, please specify

Please specify 'Other' reason for leaving*

Please indicate your intended start date of your leave.*

Please indicate your intended date of return.*

Do you intend to study at another institution while you are on Leave of Absence?*

If you plan to study at any other institution while on a Leave of Absence, you must get approval before you leave if you want to transfer credits earned back to your Richmond degree (see www.richmond.ac.uk/transfer-credits - complete a course approval form and attach course descriptions). Official transcripts must be sent to Richmond once you have completed the programme to confirm transfer credit.

Yes

Please choose the institution you plan to study at.*

If your institution is not listed, please select the bottom option of 'Another Institution' and specify the name in the textbox that will appear.

Please specify the institution you plan to study at:*

Terms & Conditions*

1. You will not be able to return to your studies if your financial obligations to the University have not been cleared, either past obligations or any fees owing for the semester in which you want to return. 2. The University is required to report any student who is in the UK on a student visa but who is not attending classes to the UK Home Office. This includes students who are taking a Leave of Absence. The University's granting of an LoA does not permit a student on a student visa to remain in the country while on LoA. 3. If you hold a student employment contract issued by the University, your employment will terminate under that contract when you are no longer a registered student at the University. You will be invited to a meeting with the Director of Human Resources to discuss the matter before your LoA is approved. 4. If you are funding your education through student loans (SFE or US Department of Education), you may be liable for the outstanding fees for the current term you are attending depending on your disbursement calendar.

Please consult with Jason Elliot about your potential financial liability.

I agree to the above terms and conditions.

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