Leave Of Absence Application Page 2
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24.
RETURN DETAILS
Student Service Centre
JCU Singapore
Block C, Student Services
Tel: +65 6709 3688
Email:
studentservices-singapore@jcu.edu.au
INCOMPLETE FORM OR MISSING DOCUMENTATION MAY DELAY THE PROCESS OF YOUR APPLICATION.
OFFICIAL USE ONLY
Date received: _____/_____/__________
Staff name: __________________________________________________
Current attendance rate (%): ___________________
Conduct:
Satisfactory
Not Satisfactory
Student status:
Local students
International students
NOTE:
International students must maintain a minimum attendance requirement of 90% as per Singapore immigration requirements.
5.
APPROVAL
Associate Director, Student Services
Approved
Not Approved
Comments:__________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Signature of Associate Director: ___________________________________ Date (dd/mm/yyyy): _____/_____/__________
Associate Dean – (For LOA requests only)
Approved
Not approved
Comments:______________________________________________________________________________________________
________________________________________________________________________________________________________
___________________________________________________________________________________________________
Signature of Associate Dean:_______________________
Date (dd/mm/yyyy): _____/_____/__________
Senior Associate Registrar – (For Semester leave request only)
Approved
Not approved
Comments:______________________________________________________________________________________________
________________________________________________________________________________________________________
___________________________________________________________________________________________________
Signature of Senior Associate Registrar:_______________________
Date (dd/mm/yyyy): _____/_____/__________
Leave of Absence Application (Revised March 2015)
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