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Topics: Brisbane, Griffith University, Queensland Pages: 4 (1486 words) Published: October 16, 2014
LOA
LEAVE OF ABSENCE
CANCELLATION OF ENROLMENT
1. PERSONAL DETAILS
Family name:

Home telephone number:

First name:

Work/mobile telephone number:

NOTE: This form is NOT to be used by students undertaking Research Higher Degrees, Miscellaneous Studies, or Cross-Institutional Study. If you are an International student you must make an appointment with an International Advisor before completing the form. Students undertaking Honours Programs should use the Change to Course Enrolment/Cancellation of Enrolment/Leave of Absence form.

Program code:

Program title:

Are you an International Student?  Yes: you must complete section 5. QCGU Students only:

Major Study Teacher: ...............................

 No: do not complete section 5.

Instrument: ..........................................

2. LEAVE OF ABSENCE
I wish to take Leave of Absence at Griffith University from: I intend to return to study at the beginning of:

Semester:

Semester:

Year:

Year:

Reasons for requesting Leave of Absence (International students please use Section 5): You will be advised of the outcome of your Leave of Absence request via email to your student email account.

3. CANCELLATION OF ENROLMENT
To cancel your enrolment at Griffith University, please tick the box below and attach a photocopy of your Griffith Identification Card.



Please cancel my enrolment at Griffith University from Semester _______ Year _____.

An email advising you of your cancellation will be sent to your student email account.

4. STUDENT SIGNATURE
I have read and understood the information on this form and understand that there will be financial and academic consequences for withdrawing my enrolment after the Census date. I have read Section 10.0 of the Student Administration Policy and will be able to

complete my program of study within the maximum time frame allowed under this Policy. I understand that if I change address while on Leave of Absence, I...
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