Leave of Absence request form
This form is for matriculated undergraduate students only. Contact Sherill Anderson: firstname.lastname@example.org with any questions. This form notifies the College of your intent to leave. If you are currently enrolled in classes and/or living on campus, submitting this form will withdraw you from classes and notify housing. A Leave of Absence is valid for up to three consecutive semesters.
Graduate students should contact the Graduate School for information about withdrawing from Brockport.