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Application for leave of absence

Enrolling Enrolment details Enrolment dates Course enrolment Changing enrolment Interrupting studies   Cancelling enrolment   Leave of absence Summer Program Studying individual units

[Print-friendly version] Using this online form Fields marked with * are compulsory fields. Use the 'Tab' key to move between fields. You will receive a confirmation email after you have successfully completed this form. 1. Are you an international student? *a) Are you an international student? Yes (Do not proceed any further. Your admission application is submitted on an LI Form.) No (Proceed with this form) 2. Your personal details Please ensure your details are updated on QUT Virtual. a) QUT student ID number N *b) Given name *c) Surname (family name) *d) Date of birth Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year *e) Reply email address This form cannot be processed unless you enter a valid email address. This email address may be used to communicate with you until your QUT email is activated. After this, QUT will communicate with you via a standard QUT student email address. *f) Contact telephone number (daytime and/or mobile) Please tick if you DO NOT wish to receive text messages via SMS from QUT. 3. Course information *a) Faculty Please select Built Environment and Engineering Business Creative Industries Education Health Humanities Program Information Technology Law Science Double degree *b) Course code (eg BS56) *c) Course title d) Major A (if applicable) *e) Campus Caboolture Carseldine Gardens Point Kelvin Grove When do you expect to complete this course and graduate? *f) Year *g) Period SUM MID END 4. Details of your proposed leave of absence *a) When should the Leave of absence take effect?   Immediately - leave will commence from today's date Later - leave will commence after the results for the current teaching period are finalised. Note: If you wish to interrupt your studies immediately and it is after the final date to withdraw without academic penalty, a result of 'Withdrawn – Failure will automatically be applied to affected units. *b) Semester to recommence studies - Choose year - 2008 2009 2010 - Choose teaching period - Semester 1 Semester 2 Summer 6TP1 6TP2 6TP3 6TP4 6TP5 6TP6 Other - please specify in 4 c) c) Applicants who are: seeking a commencing leave of absence seeking leave longer than 12 months studying post-graduate courses where leave is not automatic you will need to provide an additional supporting statement and/or attach supporting documentation (optional). Where no supporting statement is supplied, the application may be rejected or shortened without reference to the student.   d) Will you be submitting supporting documents with this application? Yes, I will submit supporting documents to QUT by post or at a Student Centre. Please attach this cover sheet. Yes, I will attach supporting documentation using the file upload function. (See section 5) 5. Supporting documentation Use the file upload function to attach supporting documentation. (Not to be used for documents that need to be original or certified copies eg academic transcripts.) Limit = 1MB 6. Privacy Details of QUT's practices regarding student information and privacy are available from QUT's privacy webpage (opens in new window). 7. Declaration By submitting this online application I agree to obey the statutes and rules of Queensland University of Technology as far as they may apply to me. I declare that to the best of my knowledge the information supplied herein is correct and complete. I acknowledge that the submission of incorrect or incomplete information may result in a cancellation of enrolment at any stage. I recognise that it is my responsibility to provide all necessary documentary evidence of my qualifications and experience and authorise QUT to verify such records through QualSearch. I authorise the University to obtain and verify further information with respect to my application and, if necessary, provide information to educational institutions, admission centres and government, legal or other regulatory authorities. QUT shall not be liable for any failure to provide services (including lectures, tutorials or examination results) or any teaching or other materials to students, where such failure is due to circumstances beyond QUT's control. Disclaimer: This publication is based on information available in October 2007. QUT reserves the right to amend or add to the details as they become necessary. * I accept the above terms and conditions. 8. Checklist *Have you: completed all sections? read QUT's privacy statement? read the declaration and agreed to the terms and conditions? printed a cover sheet if you are supplying further documentation to support your application? (optional) 9. Further information and enquiries Web: studentservices.qut.com Email: sbs.enquiries@qut.com Phone: 07 3138 2000 In person: QUT Student Centres on each campus