Returning from a Leave of Absence

Returning from a Leave of Absence Form

This application is to be used by individuals who were pre-approved for a Leave of Absence and are wanting to return. Filling out this form will assist in notifying the offices of your return to assist in registration.

Semester of Interest*
Name*
First Last
Wagner Student ID Number
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Cell Phone Number
Email*
When were you last enrolled at Wagner College?*
Please explain your reason for the leave of absence from Wagner College?*
Do you intend to study:*
- Part Time
- Full Time
Do you plan to:*
- Live on Campus
- Commute to Campus
Did you have a declared academic major as an enrolled student at Wagner College?*
- Yes
- No
Name
This field is for validation purposes and should be left unchanged.