Coursework Leave of Absence Request
Submit this form to request a leave of absence from your legal or paralegal coursework.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Program or Course Name
*
Student or Employee ID (if applicable)
Type of Leave Requested
*
Medical Leave
Personal Leave
Family Emergency
Other
Reason for Leave (Please provide details)
*
Requested Leave Start Date
*
-
Month
-
Day
Year
Date
Requested Leave End Date
*
-
Month
-
Day
Year
Date
Supporting Documentation (if applicable)
Upload a File
Drag and drop files here
Choose a file
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of
Supervisor/Advisor Name
Supervisor/Advisor Email
example@example.com
Signature (Please sign to confirm your request)
*
Submit Request
Submit Request
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