Form – Apply for leave of absence from studies

Name Both first name and surname

Personal number Enter your personal identity number or interim identity number, 12 digits (YYYYMMDDNNNN)

E-mail

Telephone number

Which semester will your leave of absence commence Specify as S24, A24, S25, etc.

Number of semesters *

1 semester
2 semesters

Programme

Yes, I consent to the storing and administration of submitted data. Information submitted here will be processed by Chalmers to administer this issue. Read more about processing of personal data at www.chalmers.se/personaldata.

After submitting your completed form, you will receive a confirmation email to the address you have provided. If you do not receive a confirmation email (also check your spam folder), please report the error by clicking on the orange button below “Leave feedback” and selecting the option “I have detected an error on the page (go to web editor)”.