[UNIST Academic Form 14] (창업휴학, 질병휴학, 임신출산휴학 등 서면휴학원 필요 휴학시, 일반휴학,군복학은 온라인 신청 가능)

Request for Academic Leave of Absence

(휴학원)

Student ID		Name		School/Dept
Degree Program	□ BS □ MS □ MS-PhD	Nationality		Type of Visa you possess
Address
Contract Info	Tel.: ( - - ) / H.P( - - )
Reason of Absence	□ Military service □ Personal Conditions -Illness - Studying -Studying abroad - Preparation for job/career -Etc.( ) – Economic Reason
Period of Absence	From( mm/dd/yy) To( mm/dd/yy) - (for ___ Semesters)
Tuition Fees	⃞ Paid ⃞ Not paid

This request is submitted for permission of academic leave of absence as specified above.

Date:______________(MM/DD/YY)

Advisor	Director of Health Care Center	School Head	Applicant: (Signature)
Name:			Guardian: (Signature)

To the President of UNIST