Request for Time Away from Washington University

From time to time students want to take time away from their studies at Washington University.

When you take a Leave of Absence from the University you have the option to return at a later date.

If you do not wish to return to the University as an undergraduate please indicate that below and your time away will be processed as a withdrawal from Washington University.

Personal Information

Student ID *

First Name *

Last Name *

Wash U Email Address *

Non-Wash U Email Address *

Primary address during absence

If your address will be outside of the United States please select "Other" from the state list (the last option) and enter as much address information as possible in the fields below.

Street Address *

City *

State *

State Other...

Zip *

Primary Phone Number *

Cell Phone Number

Expected Semester to Begin Leave *

Expected Year to Begin Leave *

Have you submitted an Intent to Graduate form? *

Yes

Would you like to withdraw your Intent to Graduate? *

Yes

Are you seeking a degree at another institution? *

Yes

Do you plan to return to Washington University as an undergraduate student in the future? *

Yes

Leave this field blank