Application for Leave of Absence Form

This form is to be completed by international students who wish to apply for a leave of absence. A leave of absence will be granted in compassionate or compelling circumstances as per organisation’s Deferral, Suspension and Cancellation Policy and Procedure. Students are required to provide documentary evidence of such circumstances.
Your visa may be affected by your application so you should contact DHA on 131881 to discuss.
Student Name:
Student ID:
Date of Application:
DD slash MM slash YYYY
Course Id
I wish to apply for a leave of absence from the course I am enrolled in with organisation, I wish to have this absence for the following for the following reason:
I have discussed the reasons for the leave of absence with the admission team
- Yes
- No
Have your contact details changed since you last advised us of them?
- Yes
- No
Residential Address:
Suburb & Country:
Postcode:
Tel (Home):
Tel (Work):
Mobile:
Email
Signature
Date
DD slash MM slash YYYY