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UNI\TEItSITY

501.i I l l l'1 li \
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iJlr,IlL$ljr ,l\ri IntefnatiOnal StUdgnt
Leave of Absence Form
stndent'Details
Full Name ffur:F-'Ra \,flR4\1LAN DAv\o
Student Number Lltt +rr85 3
G;;";Absence D'etdil" i.'

tr Semester 1 E[Serester 2

I will be in Australia over this period of tr Yes trNo €-0nknown


absence
I have provided supporting documentation of my
compassionate or compelling circumstances in accordance g'res nNo
with th e aqwes"srn * rlt,,"ryf .stre*i a i .e if*"f* ffi'rs&.m ffi.gqp P f$c"e.d r#. q.4

x Applications without supporting documentation will not be approved as this is a


requirement of the 74aa;z*WLffi*dq *Ws.*t C*AqetiE{'* aWfr TY4|.W|*-W^E*
Qve{seas €ELtde.fit$

Student Authority

Student
Signature
Date: oi \o1[ ,o'i

Please Note: Leave of Absence is for continuing students only and for a maximum of one academic
year. Leave will be processed on a semester by semester basis.
Courses for the current year will be dropped if Leave of Absence is approved.
All periods of Leave of Absence will count towards the maximum time allowed for completion of the
program.
Further information on Leave of Absence go to hltp:/lpolicy.usq.edu.aulcjocurllt,\:!:j_1_41442.L.
Students are automatically returned from a leave of absence prior to the commencement of the next
academic semester.

Submit form along with supporting documentation to is.su.pp*rt$arqq"rydu

IJSQ collects, handles, uses, discloses and stores information about you and the choices available to you for provision of
products and services selected by you throughout your learning journey. Not all of the information is personal information
under the Privacy Act 2009 (Qld). To comply with legal and administrative obligations information is disclosed to
Commonwealth and State agencies. Personal information will not be disclosed to third parties other than a USQ approved
educational services agent, partner or organisation who provides sponsorship to you for your studies, without your consent
unless required or permitted by a law. Where we disclose to a third party we endeavour to ensure they are bound by the
same requirements as USQ with respect to personal information. Transfer of personal information outside Australia may occur.
You have the right to access your personal information and if you wish to inquire about the handling or seek access to your
personal information.you can contact the USQ Privacy Officer (p-riu.ai:rtit!:isti,${ir;,tti.

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