Overseas Study Leave Of Absence Application Form

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University of Hawaiÿi at Mänoa
Overseas Study Leave of Absence Application
An overseas study leave of absence is required for any Fall or Spring term for which a student wishes to enroll in classes at an
overseas institution. Courses must be taken at an institution recognized by the University of Hawaiÿi at Mänoa in order to be eligible
for transfer. Courses taken at a recognized institution are evaluated on an individual basis and may or may not be awarded transfer
credit. More information on transferability of specific courses is available from the Office of Admissions and Records. Return the
signed application to your College Student Services Academic Office for review.
Please Type or Print:
UH Number:______________
Name:
____________________________________________________________________
Family/Last
First
Middle
Name and Location of Overseas Institution
Name ______________________________________________ Location ___________________________________________
City/Country
First Semester of Leave _________________________
Semester of Return ___________________________
International Students: Nonimmigrant students and their dependents must maintain an appropriate visa status at all times.
Are you a U.S. permanent resident? ___ Yes ___ No. If no, indicate visa type (e.g. J-1, F-1): _________________________
Will you remain in the U.S. during this period? ___Yes ___No. If no, I will depart the U.S. on ________ and return on ________.
Please read the following and sign below:
You must notify the Office of Admissions and Records (Residency Officer) of any change in your tuition status.
You must return to the same college, major and degree program that you left.
If you do not re-enroll for the approved semester of return, as indicated above, you will be considered to have withdrawn
without notice; and will be required to apply for re-admission using the System Application Form (including application
fee); and will be subject to the core, major and graduation requirements in effect at the time of re-enrollment.
If you should be placed on probation, suspension or dismissal, your leave will be canceled. Suspended or dismissed
students are required to satisfy the conditions of his/her academic action.
If you have ever received a financial aid loan, this leave of absence may not defer your loan. Please check with your loan
servicing company if you have questions.
To REGISTER for classes when you return (the semester indicated above), please visit the MyUH Portal. Important
registration information will be sent to your hawaii.edu email account.
______________________________________
______________
Student’s Signature
Date
TO BE COMPLETED BY STUDENT ACADEMIC SERVICES OFFICE
This Overseas Study Leave of Absence Application is approved/denied.
_______________________________________________________________
_____________________
Student Academic Services Representative (print name and sign)
Date
ADMISSIONS AND RECORDS USE ONLY
st
st
Before 1
Day of Instruction
On or After 1
Day of Instruction
______ Cancel Registration
______ Complete Withdrawal
Update General Student
________ Enter Leave Code (E)
________Create new general student for returning term
________ Enter Leave Dates
________Update admit term on general student to allow registration.
International Student Information
________ Verify Visa Status
________Copy to ISS if International Student
Entered By ________________________________________
Date _______________
rec/manual/leave of absence/loa_overseas.doc
Revised 04/10

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