If a leave of absence is NOT approved,*
you will be withdrawn from the College.

*This does not necessarily mean that you will be awarded "W" grades in your classes

** Documentation will be required if the leave of absence request is submitted 
   after the the last date for withdrawal from classes during regular term.

   My reason for requesting this leave of absence is as follows: (Indicate those which
   apply using the following codes.) 

CM=Change of Major**                    FP=Family Problem/Emergency**
ML=Medical Leave**                      FI=Financial**
MS=Service in Military**                PS=Personal**
WK=Employment**                         **Other: give specifics below
The following information must be completed for a leave of absence to be considered.
Email, Address (and phone number, please) where a response can reach you:
College (Edisto) E-Mail Address:
Ex: name@edisto.cofc.edu
Name (last, first, middle):
Student ID#:
Date of Request:
(Ex. 00/00/00)
Leave Term(s) Requested:
(Ex. Spr 2006, Fall 2006, etc.)
Major: Advisor:
Reason(s):
(see codes above)
**Other:
Address
(include Apt #):
City, State, Zip:
Phone #:

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