Return From Leave of Absence Request

After speaking with your Program Advisor, use this form to let the Master's & Certificate Programs office know that you are requesting to return from leave and need your student record reactivated.

Penn ID
Must be 8 digits. Currently Entered: 0 digits.
Your Penn ID can be found under your picture in Penn InTouch or on your Penn ID card--the 8, bolded numbers.
Confirm Penn ID
Must be 8 digits. Currently Entered: 0 digits.
Name Name First Last
Which Program are you returning to?
Select the term in which you are requesting to return to.

Select the term in which you intend to register. If you are requesting an extension of your leave, select the new term in which you expect to return.
Year of Term
Will you be taking a course in the term you are returning to?

Will you be taking a course in the term you are returning to? Yes No
In what term (i.e. Fall 2022) do you expect to graduate from the program?
Non-Penn Email (i.e. @gmail.com)

Confirm Email Address

Leaves often deactivate your Penn email address or limit your access to it. Please provide a non-Penn email address that you check regularly, in case we need to reach you before you are returned from leave.