Leave of Absence / Withdrawal Official Request

Please note, the leave of absence / withdrawal official request form below is for use only by undergraduate degree candidates who have already discussed their plans, and related options and implications, with an associate director at the University Service Center, or who have scheduled an appointment for such a discussion. Metropolitan College students, graduate students, and non-degree, visiting, non-matriculated, and summer guest students should follow the leave of absence / withdrawal / course drop processes as outlined by the respective academic areas.

If you have questions or concerns, you can always reach us by phoning 617-358-1818.

Please remember that tuition and fees are canceled in accordance with the University’s withdrawal and tuition refund / cancellation schedule.

Required questions are marked with red asterisks (*)

First Name:*		Last Name:*
BUID:*		Phone Number:*
BU E-mail Address:*
Request Type:*
School / College:*

Are you an international student studying in the United States on a student visa?*	YesNo
Do you have on-campus housing?*	YesNo
Are you a varsity athlete?*	YesNo

Leave of Absence or Withdrawal Effective Semester:*		Leave of Absence or Withdrawal Effective Year:*
Leave of Absence of Withdrawal Return Semester: (For Withdrawal, select “None”)		Leave of Absence of Withdrawal Return Year: (For Withdrawal, select “None”)

Please indicate the reason(s) you are arranging this leave of absence / withdrawal. (Use as much space as you need.)*

I understand it is my responsibility to keep contact information up to date via the Student Link and to check my BU student email account or to arrange email forwarding.*

I have obtained any necessary approvals or signatures and understand if I have not arranged this, my request may not be processed. I am aware my request is effective the date all required materials and approvals are received at the USC, and my tuition and fees will be adjusted according to the published refund schedule, found at http://www.bu.edu/reg/dates/withdrawal-and-tuition-refund-schedule/, using that date.*

I understand it is my responsibility to consult with an academic advisor about the academic implications of a leave or withdrawal prior to finalizing any action with the University Service Center.*

Upon successful submission of this form you will be directed to a confirmation / thank you page. Please be patient as submission can take a few moments.