Withdrawal/Leave of Absence

Please complete this form to initiate your request for Withdrawal or Leave of Absence from the University. Ensure all required fields are filled out accurately. Withdrawal may impact your academic record, financial aid, or visa status. Be sure to consult with an adviser before submitting this form.

SPACE

Student Information

SPACE

Banner ID

First Name

Last Name

SPACE

JCU Email

Personal email for future communications (NOT your JCU email)

SPACE

Current Student Type

Undergraduate Student

Graduate Student

Are you a veteran or using veteran benefits?

Yes

No

Withdrawal or Leave of Absence may have consequences for your veteran's benefits. Please contact SEFS at enrollment@jcu.edu or 216-397-4248.

Are you an International student?

Yes

No

Please contact Global Education, global@jcu.edu, to determine if there will be consequences for your visa.

SPACE

I am requesting a:

Permanent Withdrawal

Leave of Absence (limited to one year)

A Leave of Absence can only be initiated if the student does not currently have a balance and has a cumulative GPA of 2.0 or higher.

Effective:

Immediately

At the end of the semester

Plans to reenroll:

Fall

Spring

Summer

of

SPACE

Reason(s) for leaving JCU (Please select all that apply):

For what reason are you taking a leave of absence?

"Other" reason for leave of absence

What is your desired major

"Other" primary reason not listed above

What is your desired major

"Other" secondary reason(s) not listed above

In a few short words, please tell us about your JCU experience.

SPACE

Do we have permission to share information about your withdrawal or leave of absence with your parents?

Yes

No

Parent email

My signature below indicates that I fully understand that an initially approved Leave of Absence or Withdrawal is superseded in all cases by the Administrative action of academic dismissal, suspension, or expulsion.

Student Full Name

SPACE

Thank you for completing the withdrawal form. You will be contacted with further information and confirmation. We understand that deciding to withdraw is not easy. Please know that we are here to support you during this transition. If you need academic guidance, mental health support, or help with future planning, don't hesitate to reach out to your adviser or campus resources. Best wishes on your future endeavors.