Leave of Absence Form
LEAVE OF ABSENCE - STATEMENT OF INTENT TO RE-ENROLL

Student Name Printed:  

Program: Student ID #:  

I am taking a leave of absence beginning  

I certify that I will be returning to Beal University Canada  

REASON:

 

NOTE TO STUDENTS ON PROBATION: This form will not be processed if you are currently on probation or will be on probation at the end of the current mod.

NOTE TO LOAN BORROWERS: A student who stops attending during an approved loan period for any reason (approved leave of absence, medical, or otherwise), and who has future disbursements pending will have all future disbursements cancelled.

I certify that I have read the above and understand the implications of taking a leave of absence.


LOA Extension:

I would like to extend my LOA end date to

REASON:

 


OFFICE USE ONLY:

LOA Approved ⬜
LOA Denied ⬜

Date:

Signature Director Bursaries/Financial Aid:

LOA Extension Approved ⬜
LOA Extension Denied ⬜

Date:

Signature Director Bursaries/Financial Aid:

Leave this empty:

Signature arrow sign here


Signature Certificate
Document name: Leave of Absence Form
lock iconUnique Document ID: 49329b34379ebd3fc1011593633312c20f700beb
Timestamp Audit
December 27, 2023 4:26 pm EDTLeave of Absence Form Uploaded by Ginger Glodowske - gglodowske@bealuniversity.ca IP 98.53.171.23
May 28, 2024 1:32 pm EDT Document owner administrator@bealuniuversity.ca has handed over this document to gglodowske@bealuniversity.ca 2024-05-28 13:32:28 - 71.255.159.238
May 28, 2024 2:49 pm EDTStudent Services - ss@bealuniversity.ca added by Ginger Glodowske - gglodowske@bealuniversity.ca as a CC'd Recipient Ip: 71.255.159.238
May 29, 2024 9:52 am EDT Document owner gglodowske@bealuniversity.ca has handed over this document to administrator@bealuniuversity.ca 2024-05-29 09:52:26 - 98.53.171.23
May 29, 2024 9:52 am EDTStudent Services - ss@bealuniversity.ca added by Sheree Rice - administrator@bealuniuversity.ca as a CC'd Recipient Ip: 98.53.171.23