- Vermont_LeaveRequestForm

Leave of Absence Request Form

Your Name: *

First Name *

Last Name *

Address (During Leave):

Street 1:

Street 2:

City:

State:

Zip:

Phone No:

Your Non-VLGS Email: *

Date of Birth:

On what date did you last attend classes or log in to the LMS system?:

I hereby request a leave of absence from the following program(s): *

Masters - Residential

Masters - Online Learning

LLM - Residential

LLM - Online Learning

The Registrar has the authority to grant leaves of absence for only one year for Juris Doctor degree candidates who are not in mid-term. If a student requests a leave during a semester, s/he will be required to apply to the Committee on Standards. If the requested leave from the J.D. program is for one semester, you will no longer be part of a class upon your return and, therefore, will no longer be part of the class rank process. MELP and LL.M. degree candidates must resume their studies in time to complete their programs within the five-year rule. Requests for additional leaves must be made to the Committee on Standards. Please note that online learning students may return earlier to the program with prior approval of the Program Director.

Type of Leave: *

Reason for Leave:

Upload Document (if applicable):

Anticipated Effective Date: *

When do you expect to resume your studies?

Spring Summer Fall

Year:

Information Collection Disclosure: The information you enter here is retained by VLGS for internal use, and may be submitted to third-party tools or entities for specific, related purposes such as payment processing or reporting. All data is collected and retained via secure protocols. Click here to read relevant policy information.
Click here to request removal of your data.

Please check this box to indicate that you understand the data retention policy information.

NB: Submitting this form acts as your signature on this document.

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