Leave of Absence Form

Student ID or Last 4 of SS#*

Program of Study*

Please indicate semester of LEAVE*

For example - Fall 2021 or Spring 2022

Please indicate semester of RETURN*

For example - Fall 2021 or Spring 2022

As a student, you are considered an "active student" in our records for two semesters, even if not enrolled in classes. This means your email is on and we're actively trying to communicate with you. In contrast, taking a Leave of Absence has a special meaning and criteria. According to the Trocaire Catalog: A student in good academic standing, with a GPA of 2.0 or higher, who wishes to take a Leave of Absence must request this in writing to the Vice President for Academic Affairs (this form can count for that). In any calendar year, a student may be granted no more than one leave, and ordinarily it may not extend beyond one full semester. A student who does not return at the end of a Leave of Absence will be considered withdrawn from the college. This withdrawal will be effective as of the beginning date of the Leave of Absence. Except for serious reasons, a Leave of Absence will not be granted after Add and Drop day in each semester. Students granted a Leave of Absence for medical reasons must have a doctor’s release to return to the college.

Do you still want to pursue the LOA?*

Yes. And I understand that if I do not return after 1 semester I have to reapply.
No. I'm really trying to do something else. Please contact me.

A student who is returning from an official leave of absence shall make an appointment with the Advisement and Student Service Center prior to the beginning of the semester for which the student is to return. The purpose of this meeting is for the student to register for courses or, if the student is unable to return as intended, to officially withdraw from the College. Students in the AAS in Nursing Program will be notified by the Program Director when they are able to register for classes. Placement in a program, following a leave of absence, is based on space availability. The student must make arrangements to satisfy all financial responsibilities to the College prior to registering for courses.

I understand these conditions of a leave of absence:*

Yes
No

Please describe your reason for requesting a leave of absence:*

Signature*

By checking this box, typing my name below, and indicating today's date, I am electronically signing this form.

Date*

Name*

First Middle Last

Email*

Please enter your Trocaire.edu email address