APPLICATION FOR LEAVE OF ABSENCE INSTRUCTIONS 1. Complete all relevant sections of the application. 2.

Closing Date: 3 weeks after beginning of session 3. Applications must be supported by appropriate documentary evidence. PERSONAL DETAILS UOW Student No:_______ Family Name:____________ First Name:______________ Title:_____ Course Code:____________ Course Name:____________ SUPPORTING INFORMATION Leave of Absence requested for: (please tick one of the following). Please note that Leave of Absence can only be granted for a maximum of 1 (one) calendar year which is equivalent to 4 consecutive sessions) o o o o Session 1, 200__ Session 2, 200__ Session 3, 200__ Session 4, 200__

Have you previously been granted a Leave of Absence?_________________________Yes/No If yes when: _____________________________ Full details must be provided and documentation supplied to support your situation (Attach extra sheet if necessary):

STUDENT SIGNATURE Signature: _____________________________________ APPROVAL Approved/Not Approved: UOW Program Co-ordinator Date: Date:_____________________

Send Applications To: Singapore Institute of Management 461 Clementi Road Singapore 599491 Ph: 6248 9688 Fax: 64629263

Reason: