Application For Leave From Study
Application For Leave From Study
Application For Leave From Study
THE HONG KONG UNIVERSITY OF SCIENCE & TECHNOLOGY Admissions, Registration & Records Office
3. 4. 5. 6.
Application Procedures
1. Undergraduate students who wish to take leave from study should complete Sections I & II below, and submit the form with appropriate supporting documents to the program department for approval.
2.
I.
Student Particulars
Student Name :
(In English)
a. b. c. d. e. f.
Employment Financial hardship (please approach SAO for assistance if necessary) Health ( medical certificate enclosed, if any) Heavy academic workload Joining internship or co-op program Others (please specify) :
YES
NO
If yes, please state the leave period : __________________________________________________________ I declare that all the information given above is true and correct to the best of my knowledge.
Signature of Student
Date
[Please pass this Form to the Deans office for endorsement if the period of leave from study is for two or more consecutive semesters.]
Name
Date
Signature of Dean
Name
Date
[Please note that application for leave from study for more than two consecutive semesters should be directed to the Office of the Provost for approval.]
V.
Result Received On by
Student Notified on
Remarks :