::: academic leave request form

     A student wishing to leave LCC voluntarily for a limited period may choose to be classified as a student on academic leave.  Application for academic leave should be made during the semester prior to the intended leave.
     Under unusual circumstances (to be determined on an individual basis by the Academic Vice President), a student may request academic leave within the semester they are currently in, but only up to the end of the ADD/DROP period.  After this date, all leaves will be treated as withdrawals (or withdrawn/failure) or incompletes.
     Academic leave will be granted for periods of up to one year.  When a student has been absent for more than one year, the student will be considered withdrawn from LCC, and this will be noted on the student's transcript.
     Students on official leave shall retain all the catalog privileges of continuous  enrolment.  Students should be aware of the consequences of stepping out of the annual sequence of courses. Additional semesters may be required in order to complete the program.
     Academic leave counts towards the 7 years required to complete the degree requirements for graduation.  Students may not have outstanding debts (tuition, library, dormitory) when going on academic leave. 

The following student has requested permission to be granted academic leave:
Last Name: First Name:
Leave requested for the period of:
Reason for request:

Please confirm that the student has met all obligations and is aware of the consequences of taking academic leave by signing and dating this form:
Academic Advisor: Date:
SFS Director:           Date:
Librarian:                 Date:
Resident Director:  Date:  

Final approval granted:
Registrar: Date:

All offical LCC information (including registration info) will be sent to the student's LCC email address. Student contact information while on leave:
Address:
Telephone: LCC Email:

Please contact the Registrar's Office (registrar@lcc.lt) by April 1 if you plan to resume your studies during the upcoming fall semester. Contact us by October 15 if you plan to resume your studies during the upcoming spring semester. 
INTERNATIONAL STUDENTS must contact Migration Affairs Coordinator at visa@lcc.lt 7 months prior to the semester of reenrollment.

By signing below I indicate my understanding and agreement with the policy.
Signature: Date: