Leave of Absence Form | College of Fine Arts

Personal Information

Legal Name*

First Last

Preferred Name (if different from above)

First Last

BU ID#*

Please enter your BU ID# without spaces (e.g. U12345678)

BU Email Address*

Non-BU Email Address*

Permanent Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

I am an*

Online Student
On-Campus Student

Please select your school.*

SOM
SOT
SVA

Please select your degree program.*

PhD students must request a Leave of Absence, and an extension for funding, from the Associate Dean of Academic Programs and Enrollment in the CFA Dean’s Office.

Please select your degree program.*

BA
BFA
MFA
Artisan Certificate

Please select your degree program.*

Program of Study*

Start of Leave

Please check this box if you have previously taken 2 semesters off

I have previously taken 2 semesters off

Please check this box if you have previously taken 4 semesters off

I have previously taken 4 semesters off

Please provide a plan for completing the program (semesters and courses to be taken in those semesters) before we review your request for an additional semester of leave:*

Semester Leave will Begin:*

Fall
Spring

Year Leave will Begin:*

Returning from Leave

Semester to Return from Leave:*

Fall
Spring

Year to Return from Leave:*

Please state your reason for requesting a leave of absence.*

Please upload a plan of study, semester by semester, through graduation.*

Drop files here or

Max. file size: 100 MB.

Are you an international Student in F-1 or J-1 immigration status?*

If yes, you must consult with your ISSO advisor prior to taking a leave of absence. More information is available here: http://www.bu.edu/isso/

Yes
No

Name of Academic Advisor

Date of Meeting with Academic Advisor

I. Please indicate the 7-week semester and year that this leave will take place.*

Year*

II. Current Coursework*

I am currently registered for . Please drop me from this course.
I am not registered for a course in this semester.

If you are registered for multiple courses, please input each course code, separated by a comma.

III. Are you receiving federal loans through Boston University?*

Yes
No

IV. Reason for Leave*

Please choose only one.

Medical (Documentation will be required for consideration to return)
Personal
Financial
Professional
No courses offered for me to take
Result of approved petition (qualifying exam, extended LOA, etc.):
Other:

Agreement

CFA Student Signature*

By checking the box below, I acknowledge that I have read the Leave of Absence Policy as outlined above by the College of Fine Arts and understand how it may affect my housing, financial aid, visa (if applicable) and rate of degree/program completion. The information provided in this form is true and accurate.

Yes, I agree.

Today's Date*

NOTES:

You will receive an email when this form has been processed. If you do not receive an email confirmation within one week of submitting the form, you can assume it was not received or processed. If this is the case, please resend the form. It is your responsibility to confirm that the form was processed. This form must be complete in order to be processed.
Students will continue to stay active in the BU system while on a LOA and will receive emails and have access to the library.
If you are having trouble submitting this form, send a detailed e-mail to Shannon Streets.