Leave of Absence


Leave of Absence Form

Student Name:  

Location:  

Instructor:  

Program:

Class Day of Week: Time of Class:  

Date of Class Start: Last Date of Attendance:

 

By digital signing this document you are agreeing to and understand the TMIKY Leave of Absence rules and regulations that have been laid out in the TMIKY Catalog. After submission this document will be sent to the proper channels for approval. Your TMIKY representative will reach out once approved. Please email us at [email protected] if more guidance is needed. 

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The Medical Institute of Kentucky https://tmiky.com
Signature Certificate
Document name: Leave of Absence
lock iconUnique Document ID: c65a319e5d1b5d0337ad90d427a3f2fe43a94b63
Timestamp Audit
November 19, 2019 4:12 pm GMTLeave of Absence Uploaded by Cassie Black - [email protected] IP 99.190.9.234
December 16, 2019 5:31 pm GMTEnrollment Agreements - [email protected] added by Joel Nivens - [email protected] as a CC'd Recipient Ip: 65.29.85.242
December 16, 2019 5:33 pm GMTEnrollment Agreements - [email protected] added by Cassie Black - [email protected] as a CC'd Recipient Ip: 65.29.85.242
May 1, 2020 2:28 pm GMTEnrollment Agreements - [email protected] added by Cassie Black - [email protected] as a CC'd Recipient Ip: 71.143.223.187
June 5, 2020 1:19 pm GMTEnrollment Agreements - [email protected] added by Cassie Black - [email protected] as a CC'd Recipient Ip: 71.143.223.187
July 21, 2020 6:44 pm GMTEnrollment Agreements - [email protected] added by Cassie Black - [email protected] as a CC'd Recipient Ip: 99.190.9.234
September 10, 2020 2:53 pm GMTEnrollment Agreements - [email protected] added by Cassie Black - [email protected] as a CC'd Recipient Ip: 99.190.9.234
September 18, 2020 1:23 pm GMTEnrollment Agreements - [email protected] added by Cassie Black - [email protected] as a CC'd Recipient Ip: 99.190.9.234