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Office of The Vice President For Academic Affairs: Leave Information

This document is a leave of absence form for students from an Office of the Vice President for Academic Affairs. It requests information such as the student's name and ID, course and year level, and reason for leave. It asks for the begin and estimated return dates for leave of absence. The student and dean must sign and date the form, which also requires supporting documents and approval from the VP of Academic Affairs.

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Felyn Garbe Yap
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37 views2 pages

Office of The Vice President For Academic Affairs: Leave Information

This document is a leave of absence form for students from an Office of the Vice President for Academic Affairs. It requests information such as the student's name and ID, course and year level, and reason for leave. It asks for the begin and estimated return dates for leave of absence. The student and dean must sign and date the form, which also requires supporting documents and approval from the VP of Academic Affairs.

Uploaded by

Felyn Garbe Yap
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Office of the Vice President for

Academic Affairs
LEAVE OF ABSENCE FORM

Student Information
STUDENT NAME
STUDENT ID NUMBER
COURSE
YEAR LEVEL
DEPARTMENT

LEAVE INFORMATION
BEGIN LEAVE ABSENCE ON
(MM/DD/YEAR)
ESTIMATED RETURN FROM LEAVE ON
(MM/DD/YEAR)

___Employment

___Health Concern

REASON FOR LEAVE ___Financial Concern

___Pregnancy

___Travel Abroad

___Others, please specify:

SUPPORTING DOCUMENT(S)

SIGNATURE OF PARENT OR GUARDIAN


DATE

OSA Chairperson
Signature over Printed Name
Date

Dean
Signature over Printed Name
Date

Approved:

SUSAN O. DANGAN, EdD


VP for Academic Affairs

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