MSD Course Section Swap or Leave of Absence Request Form

This form is for MSD students only to request:

1. a change of section for a course or

2. a leave of absence

The student desiring a change to another section will need to find a student who wants to switch out of the class the first student wants and into the class that the first student is leaving – a swap of sections. We do this to maintain the highest level of faculty support for all the students, so that each student receives the professor’s maximum attention.

Students may change from one section to another only by making a swap with another student already enrolled in the course that’s being requested. One student may fill out the form for both. Please note that these change requests may not be processed until the weekend before the course starts and will be immediately visible in the student portals of both students when the change has been made.

Type of Request: *

Course Section Swap

Leave of Absence Request

First Name *

Last Name *

Email Address *

Course you want *

Block * 🛈

Year *

Course Request

Student #2 First Name

Student #2 Last Name

Course you want

Block 🛈

Year

Leave of Absence Request

MIU ID *

Start Date of Your Leave of Absence: * +

End Date of Your Leave of Absence: * +

By checking the box below you are certifying that if you leave Jefferson County, you agree to 14 days of isolation before returning to campus. *

I agree to isolation if I leave Jefferson County

I do not agree to isolation if I leave Jefferson County

Please provide your contact information during this time:

Street Address *

Address Line 2

City *

State/Province/Region *

Zip/Postal Code *

Phone Number *

Country *

Reason for request: *

Please note: missing a block means that you will have to re-register for the course you are missing. Please contact your advisor for guidance.

Advisor *

Al-Tarawneh	Corazza	Inan	Kalu	Khan	Lerman
Lester	Li	Mohanraj	Mukadam	Najeeb	Rao
Ruby	Saad	Sander	Inan	Xing	Zijlstra
My advisor not on list