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Leave of Absence Application Form


Instructions

Please read the Leave of Absence policies before completing this application to be sure you are seeking the appropriate leave for your circumstances. The form and policies can be found at http://www.du.edu/studentlife/advising/policies-forms/index.html

 
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Please Provide Your Information Below

Please provide contact information for where you can be reached while on leave of absence

Involved party 1

Questions

Are you an international student?(Required)
This field is required.
If you answered "yes" to the above question, have you met with an ISSS advisor?
This field is required.
Do you have financial aid?(Required)
This field is required.
If you answered "yes" to the above question, have you met with a Financial Aid Counselor?
This field is required.
Do you have health insurance through DU?(Required)
This field is required.
If you answered "yes" to the above question, have you contacted HCC?
This field is required.
Do you live in the residence halls?(Required)
This field is required.
If you answered "yes" to the above question, have you met with your RA or Resident Director?
This field is required.
Do you live in Greek housing?(Required)
This field is required.
If you answered "yes" to the above question, have you met with Greek Life?
This field is required.
Have you previously taken a Medical Leave of Absence?(Required)
This field is required.
This field is required.
Please check all that apply(Required)
You must make at least one selection.
Terms for which leave is requested(Required)
You must make at least one selection.
This field is required.
Term in which you plan to return to study (one year maximum)(Required)
You must make at least one selection.
This field is required.

Submission