Free Leave of Absence Request (School) Template

[Your Full Name]
[Student ID]
[Course / Department]
[Email] | [Phone]

[Date]

[Course Director / Registrar]
[University / College]
[Address]

Dear [Name],

Re: Request for leave of absence — [Academic Year / Term]

I am writing to formally request a leave of absence from my studies on [Course Name], [Year of Study], for the period [Start Date] to [Return Date].

Reason for the request:
[Brief, honest explanation — e.g. "I have been advised by my doctor to take a period away from study to recover from [condition], and I do not believe I can give my course the focus it requires during this time." / "A serious family situation requires my full attention and presence at home for the next [period]."]

Supporting evidence is attached:
• [Medical letter / consultant note / supporting statement from student services]

Plan during the leave:
• I will [keep in regular contact with my personal tutor / not engage with course work during the leave / undertake [specific activity]].
• I have spoken to [Tutor / Counsellor / Adviser] who is aware of my situation.

Plan for return:
• I intend to return to studies in [Term / Year], rejoining [Year of Course].
• I have / will speak with [Funding Body / Accommodation / Visa Office] to confirm the implications and arrangements for my return.

I would be very grateful if you could:
1. Confirm in writing whether the leave is approved.
2. Confirm the impact on my [tuition fees / funding / visa / accommodation], or signpost me to the right people.
3. Let me know what I need to do nearer the time to formally return.

Thank you for considering this request. Please contact me on [Phone] or [Email] if you need any further information.

Yours sincerely,

[Your Full Name]
[Student ID]