REQUEST FOR LEAVE OF ABSENCE / VACATION

Name *

Request Date *

SEVIS # *

Status *

[radio* student_status use_label_element "Domestic" "Overseas"]

Present Address *

Phone *

Email *

Type of Leave (check one) *

[radio* leave_type use_label_element
"Annual Vacation / Personal Leave of Absence"
"Medical / Family Emergency / Service Leave of Absence"]

Desired Leave of Absence Period *

From:
To:

Reason for Request *

Next Session Start Date *

Required Initials (Type your initials)

1) I am following all the laws and regulations of the United States and AOI policies.

2) In case of changes in the stated plan above, I will immediately notify AOI and follow school procedures.

Important Notice

• Planning a vacation implies that the student is intending to enroll at and/or continue their education with AOI.
• If a student does not return to AOI following their vacation, the student's 60-day grace period will start on the last day of the session prior to the student's vacation.

Student Statement

All the information on this form is about myself. It is true and correct to the best of my knowledge.

Date *

Student Signature (Type full legal name) *