QUT | Student Services | Application for leave of absence

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.

2. Your personal details

Please ensure your details are updated on QUT Virtual.

a) QUT student ID number

*b) Given name

*c) Surname (family name)

*d) Date of birth

Day

Month

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

*b) Course code (eg BS56)

*c) Course title

d) Major A (if applicable)

*e) Campus

Caboolture
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

Next teaching period- leave will commence after the results for the current teaching period are finalised.

Future teaching period - specify the teaching period you wish the leave to commence below

If you select Future teaching period, you are required to select teaching year and periods below.

* i) Teaching Year

* ii) Teaching Period Category

* iii) Teaching Period

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to interrupt your studies immediately and it is after the final date to withdraw without academic penalty, a result of 'Withdrawn - Failure will automatically be applied to affected units.

Note: You will be notified by email of the outcome of your request, usually within 14 days. A formal Leave outcome letter will be mailed to you at the commencement of your Leave period.

*b) Semester to recommence studies

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 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 (opens in new window)..

Yes, I will attach supporting documentation using the file upload function. (See section 5)

7. Declaration

By submitting this online application I agree to obey the statutes and rules of Queensland University of Technology as far as they apply to me. I further agree to comply with any policies or procedures of the University governing my conduct as a student and academic matters affecting my studies, including but not limited to, policies or procedures governing acceptable use of the University's facilities.

I declare that to the best of my knowledge the information supplied by me is true, correct and complete in every respect. I acknowledge that the submission of false, incorrect, incomplete or misleading information may result in cancellation of my enrolment or delays in processing.

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. Such circumstances include, but are not limited to, natural disasters, malicious damage, outbreak of pandemic disease, industrial action or strikes, acts of war or acts of God.

I acknowledge that it is my responsibility to provide all necessary documentary evidence of qualifications or experience. I authorise QUT to verify such records through QualSearch or grant my consent for other educational institutions, admissions centres, government bodies or employers to disclose information about my qualifications and experience directly to QUT.

Disclaimer: This publication is based on information available in December 2009. 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)

Application for leave of absence

Using this online form

1. Are you an international student?

2. Your personal details

3. Course information

4. Details of your proposed leave of absence

5. Supporting documentation

6. Privacy

7. Declaration

8. Checklist

9. Further information and enquiries