Withdrawal / Leave of Absence Request Form

Students who wish to withdraw from studies or take a leave of absence (hiatus) need to complete this form. A withdrawal or leave of absence can impact a student's eligibility for Canada Student Loan and Study Permit for study in Canada. It is important to discuss the impacts of a withdrawal or leave of absence with your Academic Advisor. A permanent mailing address is required for future communication.

Tuition refunds and material fee reimbursements for students withdrawing from studies once a term has begun will be consistent with the posted refund dates. Students who withdraw completely from the current term before the 100% refund date will be charged a $100 withdrawal fee. See the NSCAD website on tuition fees for full fees, tuition, and refund dates.

Name Name First Last
Student ID
Month and Day of Birth (MM/DD)
Email
Permanent Mailing Address Permanent Mailing Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Leave of Absence

Leave of Absence Fall Winter
Expected Semester of Return (ie Fall 2022)
Permanent Withdrawal (not returning to NSCAD University)

Permanent Withdrawal (not returning to NSCAD University) Yes
Student Program of Study

Student Program of Study Bachelor's Degree Master's Degree Visual Arts Certificate PBAC Exchange Student

Please check one.
Student Status
Are you on a Student Loan?

Student Status Are you on a Student Loan? Yes No I am an international student

Check one.
Reason for Withdrawal / Leave of Absence

Reason for Withdrawal / Leave of Absence Financial reasons Personal withdrawal (I would prefer not to state) Academic difficulty Medical Transfer to another institution Dissatisfied with the program

Please select all that apply and elaborate in the text box below if you wish.
Details
Student Signature

Draw or Type

I understand that by submitting this signed form I am declaring my desire to withdraw or take a leave of absence from my studies at NSCAD University. There are financial implications to my actions. I have discussed the implications of my withdrawal with my Academic Advisor. I understand that returning to studies after more than one academic year may change my degree requirements. Clear

Full Name

I understand that by submitting this signed form I am declaring my desire to withdraw or take a leave of absence from my studies at NSCAD University. There are financial implications to my actions. I have discussed the implications of my withdrawal with my Academic Advisor. I understand that returning to studies after more than one academic year may change my degree requirements.