ࡱ> RUQ_ <bjbjjj 4H,b,b ! 44444HHH84H!@8,v}$  $#& !]4 !44,j!F44,  ;p F !0!,'AX,','4 ! !F!,' B :  Center for Professional Studies Leave of Absence Request Email this form to  HYPERLINK "mailto:cps@pace.edu" cps@pace.edu once completed Questions: Phone: (888) 561-7223 Email:  HYPERLINK "mailto:cps@pace.edu " cps@pace.edu  Website: Visit us online at HYPERLINK "http://cps.pace/edu"cps.pace.edu Name (First, Last) Contact Number Email Course Enrolled Semester Enrolled Is this an online class?* Yes  FORMTEXT       No  FORMTEXT       Are you enrolled in a tuition payment plan* Yes  FORMTEXT       No  FORMTEXT       Student Signature/E-signature (acknowledges agreement of s policies) Date Submitted Please Indicate Reason:  FORMTEXT       Medical Emergency __________________________________________________________________________________________________________  FORMTEXT       Work Obligation ___________________________________________________________________  FORMTEXT       Death/Illness of a Family Member _____________________________________________________  FORMTEXT       Family Emergency ____________________________________01KL_`·vgXvJ;h5CJOJQJ^JaJhSCJOJQJ^JaJhYW5CJOJQJ^JaJh>+5CJOJQJ^JaJhS5CJOJQJ^JaJhqh-_CJaJh-_hqCJaJh-_h-_0JCJaJjh-_h-_CJUaJh-_h-_CJaJhSCJaJh-_CJaJhQ6hYWCJaJhaACJaJh~CJaJhQ6hwYCJaJh 2PCJ$aJ$2K S T U V zJkd$$Ifs|)|)|)22s44 saytq+A P$Ifgda4#$d %d &d 'd N O P Q  [$\$gd-_          # ĵr^PĵE=EhSCJaJhQ6hSCJaJhCJOJQJ^JaJ'h-haA0J5CJOJQJ^JaJ#haAhaA5CJOJQJ^JaJhaA5CJOJQJ^JaJ&jhaA5CJOJQJU^JaJhSCJOJQJ^JaJhYW5CJOJQJ^JaJhS5CJOJQJ^JaJhYWCJOJQJ^JaJh5CJOJQJ^JaJh^5CJOJQJ^JaJ# $ C D E Q R S T U V W \ b i j l q 򻨓qeWF:.:hKCJOJQJ^Jh CJOJQJ^J h$hYWCJOJQJ^JaJh-_CJOJQJ^JaJhYWCJOJQJ^J#hYWB*CJOJQJ^JaJphhYWB*CJOJQJ^Jph)ha4ha4B*CJOJQJ^JaJph%ha4ha4B*CJOJQJ^JphhYW5CJOJQJ^JaJhaAhaA0J5CJaJ jhaA5CJUaJhaA5CJaJjhaA5CJUaJV W k l } [P P$Ifgd9vHkd$$Ifs|)|)22s44 sayt P$IfgdK 6 Jkd"$$Ifs|)|)|)22s44 sayta4q | } r z | ~ zjXM=-hB*CJOJQJ^JphhYWB*CJOJQJ^Jphh9vhYWPJaJ#h~B*CJOJQJ^JaJphh~B*CJOJQJ^Jphh^hCJOJQJ^JaJh9vCJOJQJ^JaJhKCJOJQJ^JaJ h$h~CJOJQJ^JaJh9vCJOJQJ^J#hs!B*CJOJQJ^JaJphhs!B*CJOJQJ^Jph h9hYWCJOJQJ^JaJh07DCJOJQJ^J  TMMM 6 Jkd$$Ifs|)|)22s44 saytgP$If 6 [$\$gd9vHkd$$Ifs|)|)22s44 sayt~  > @ J L ` b d ᷥrV3rEjha4h9vB*CJOJQJU^Jehphr6ha4h9vB*CJOJQJ^Jehphr?jha4h9vB*CJOJQJU^Jehphr%ha4h9vB*CJOJQJ^Jph"h+[5B*CJOJQJ^Jph"h9v5B*CJOJQJ^JphhKCJOJQJ^JhYWCJOJQJ^Jh9vCJOJQJ^J#hYWB*CJOJQJ^JaJph d n p | ~   " * , @ ںhںVDVDVDV"h-_5B*CJOJQJ^Jph"h9v5B*CJOJQJ^JphEj|ha4h9vB*CJOJQJU^Jehphr6ha4h9vB*CJOJQJ^Jehphr%ha4h9vB*CJOJQJ^Jph?jha4h9vB*CJOJQJU^JehphrJjha4h9vB*CJOJQJU^JehmHnHphru@ B D N P \ ^ r t v ܼgD8#(h+[h+[5B*CJOJQJ^Jphh+[CJOJQJ^JEjdha4h9vB*CJOJQJU^Jehphr6ha4h9vB*CJOJQJ^Jehphr%ha4h9vB*CJOJQJ^JphJjha4h9vB*CJOJQJU^JehmHnHphru?jha4h9vB*CJOJQJU^JehphrEjha4h9vB*CJOJQJU^Jehphr  .ln<6>67gd%gd 0^`0gdKHkd$$Ifs|)|)22s44 saytg P$IfgdK 6  ~ ϿvbN6/hKhK6B*CJOJQJ]^JaJph&h9vB*CJOJQJ]^JaJph&hOfB*CJOJQJ]^JaJph,hhYWB*CJOJQJ]^JaJphhOfB*CJOJQJ^JphhYWB*CJOJQJ^Jph#hYWB*CJOJQJ^JaJphhYWB*CJOJQJ^Jphh B*CJOJQJ^Jphh"B*CJOJQJ^JphhKB*CJOJQJ^Jph&,-./0:;  0ᣇd>0hCJOJQJ^JaJJjh}tGhB*CJOJQJU^JehmHnHphruEjSh}tGhB*CJOJQJU^Jehphr6h}tGhB*CJOJQJ^Jehphr?jh}tGhB*CJOJQJU^Jehphrh%5CJOJQJ^JaJh9v5CJOJQJ^JaJh5CJOJQJ^JaJhK5CJOJQJ^JaJ08 RT龧mM16h}tGhB*CJOJQJ^Jehphr?jh}tGhB*CJOJQJU^Jehphr)h hB*CJOJQJ^JaJphhB*CJOJQJ^Jph)hhB*CJOJQJ^JaJph,hh>*B*CJOJQJ^JaJph,hh>*B*CJOJQJ^JaJph&hK>*B*CJOJQJ^JaJph,hhS>*B*CJOJQJ^JaJph  ܼvgVA%6h}tGhB*CJOJQJ^Jehphr)hhYWB*CJOJQJ^JaJph hhCJOJQJ^JaJhK5CJOJQJ^JaJ#h9vh9v5CJOJQJ^JaJh9vCJOJQJ^JaJJjh}tGhB*CJOJQJU^JehmHnHphru?jh}tGhB*CJOJQJU^JehphrEjh}tGhB*CJOJQJU^Jehphr jnpܼykK/6h}tGhOfB*CJOJQJ^Jehphr?jh}tGhOfB*CJOJQJU^JehphrhOfCJOJQJ^JaJhK5CJOJQJ^JaJhCJOJQJ^JaJJjh}tGhB*CJOJQJU^JehmHnHphru?jh}tGhB*CJOJQJU^JehphrEj;h}tGhB*CJOJQJU^Jehphr 6:6>6@6ܼyjhjY9?jh}tGh,B*CJOJQJU^Jehphrh,5CJOJQJ^JaJUhK5CJOJQJ^JaJh9v5CJOJQJ^JaJhOfCJOJQJ^JaJJjh}tGhOfB*CJOJQJU^JehmHnHphru?jh}tGhOfB*CJOJQJU^JehphrEjh}tGhOfB*CJOJQJU^Jehphr _____________________________  FORMTEXT       Birth of a Child _________________________________________________________________ Time Needed (3 months max) Policies: *Online classes will have their access turned off. Once you resume your class you course completion date will be pushed back to accommodate the leave. *Please note that students WILL NOT be refunded for the tuition they have paid under any circumstances. This includes students who are paid in full. Students on payment plans will have their payments on hold and start back up again on the first of the month beginning their re-enrollment date.     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