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Graduate Leave of Absence Form


This form is to be used for graduate students requesting a Leave of Absence from Lehigh University. Students are strongly encouraged to contact their advisors and department chairs about their plans in order to keep open lines of communication. Students should also keep in mind that while on leave, they are not registered with Lehigh University which has implications regarding student loan status, immigration status, health insurance, assistantships, and access to University services. Upon submission, information regarding your requested leave will go to your advisor, program director, funding supervisor, chair, and registrar as well other univeristy offices as required.


Please review the Graduate Leave of Absence Policy for details.

This form is to be used by graduate students only. Undergraduate Students should use the form linked HERE

Background Information

 
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Your Information

YOU MUST PROVIDE THE FOLLOWING INFORMATION Failure to do so will result in your request for a Leave of Absence being denied.

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Circumstances Regarding Leave

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Supporting Documentation

Documentation including medical documentation, should be attached to this request. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission