Health & Wellness BAS Leave of Absence Request Form

Students must attend classes every quarter as listed on their education plans in order to maintain active status in the Health & Wellness BAS program. Current students may request up to two quarters off by completing this Leave of Absence form.

This request is only good for one quarter of leave at a time. Please submit a separate form to continue your leave of absence for up to two consecutive quarters.

Health & Wellness BAS- Leave of Absence Request Form

Name(Required)

First Last

Student ctcLink ID Number(Required)

Bellevue College Email(Required)

Personal Email(Required)

Phone Number(Required)

Quarter you are requesting a leave of absence(Required)

Leave of Absences can only be requested for one quarter at a time.

Reason for Leave Request(Required)

Please give a reason for your Leave of Absence request. You do not need to give details however the more you are willing to share, the better the Health & Wellness BAS program is able to make their decision and assist you.

Last Updated January 14, 2022

Health & Wellness BAS Leave of Absence Request Form

Health & Wellness BAS- Leave of Absence Request Form

Available Forms