Leave of Absence Form
Students may review the
leave of absence policy here
. To apply for a leave of absence, students must submit this form for approval.
Please note the following:
Students who wish to take a leave of absence should contact the
Financial Aid Office
as aid may be impacted. Students should also contact
Student and Department Account Services
to make certain their account is settled prior to leaving the College.
Should your plans for returning change for any reason, you should inform your program director and the registrar's office.
If you have any questions, please call us at 503-768-6030, or email at gradreg@lclark.edu.
Today's date
First Name
Last Name
LC ID number
This is a 7-digit number.
LC Email Address
I have reviewed the
LC Graduate School Leave of Absence Policy
.
Yes
I have reviewed the
LC Graduate School Tuition Refund Policy
.
Yes
Term leave is effective
Term returning
Reason
Do you wish to drop your current classes?
Yes
No
If you wish to drop your current classes, please provide your last day of attendance for each class.
Program
Be sure to check the whole list before making your selection, especially if you are in a program with MESOL/ESOL.
Department