Vermont Law School
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Leave of Absence Request Form



First Name: *
Last Name: *
Address:
(during leave)		 Street 1: Street 2: City: State: Zip:
Phone:
Your Non-VLGS Email: *
Date of Birth:
On what date did you last attend classes or log in to the LMS system?

I hereby request a leave of absence from the following program(s): *
The Registrar has the authority to grant leaves of absence for only one year for Juris Doctor degree candidates who are not in mid-term. If a student requests a leave during a semester, s/he will be required to apply to the Committee on Standards. If the requested leave from the J.D. program is for one semester, you will no longer be part of a class upon your return and, therefore, will no longer be part of the class rank process. MELP and LL.M. degree candidates must resume their studies in time to complete their programs within the five-year rule. Requests for additional leaves must be made to the Committee on Standards. Please note that online learning students may return earlier to the program with prior approval of the Program Director.
Type of Leave: *

Reason for Request:
Documentation:

Anticipated Effective Date of Requested Leave: * (MM/DD/YYYY)

When do you expect to resume your studies?     Spring     Summer     Fall     Year
Information Collection Disclosure:

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NB: Submitting this form acts as your signature on this document.