Leave of Absence


Leave of Absence Form

Student Name:  

Instructor:  

Program:  

Date of Class Start:

Last Date of Attendance (Todays Date):

Maximum Return Date (This date must be 6 months from the date of signing this LOA):

By digital signing this document you are agreeing to and understand the TMIKY Online Leave of Absence rules and regulations that have been laid out in the TMIKY Online Catalog. After submission this document will be sent to the proper channels for approval. Your TMIKY Online representative will reach out once approved. Please email us at [email protected] if more guidance is needed. 

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Signature Certificate
Document name: Leave of Absence
lock iconUnique Document ID: 21e419f27be027764631a77c73a4ba391c3e5784
Timestamp Audit
May 16, 2022 9:33 am ESTLeave of Absence Uploaded by Cassie Black - [email protected] IP 99.190.9.234
May 16, 2022 9:34 am ESTCCT Documents - [email protected] added by Cassie Black - [email protected] as a CC'd Recipient Ip: 99.190.9.234
July 27, 2022 9:33 am ESTCCT Documents - [email protected] added by Cassie Black - [email protected] as a CC'd Recipient Ip: 99.190.9.234
July 27, 2022 9:33 am ESTCCT Documents - [email protected] added by Cassie Black - [email protected] as a CC'd Recipient Ip: 99.190.9.234
July 27, 2022 9:34 am ESTCCT Documents - [email protected] added by Cassie Black - [email protected] as a CC'd Recipient Ip: 99.190.9.234