Leave of Absence Form

Student Name:  

Location: LocationBowling GreenElizabethtownFlorenceHopkinsvilleLexingtonLondonOwensboroSomersetFort MyersOnline 

Instructor:  

Program: ProgramDental AssistantClinical Medical AssistantMedical Administrative Assistant (MAA)MAA with Electronic Health RecordsMAA with Billing & CodingMAA with Electronic Health Records and Billing & CodingMAA with Project ManagementMAA with Social Media Strategist MAA with Human ResourcesMAA with Bookkeeping and PayrollBusiness AdministrationPharmacy TechnicianPhlebotomy TechnicianElectronic Health RecordsMedical Billing & Coding

Class Day of Week: Day of WeekMondayTuesdayWednesdayThursdayFriday Time of Class: Time8:00AM - 12:00PM1:00PM - 4:00PM5:30PM - 7:30PM7:30PM - 9:30PM 

Date of Class Start:  

Last Date of Attendance (Todays Date):  

Maximum Return Date (This date must be 30 days from the date of signing this LOA):  

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. You also are signing with the understanding that you still have to complete all financial obligations including loan payments while on this Leave of Absence. 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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Document name: Leave of Absence

Unique Document ID: 3a886f721b545190f23177baf2150d2b3497742f

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Timestamp	Audit
August 19, 2022 2:14 pm EDT	Leave of Absence Uploaded by Greg Goins - [email protected] IP 99.190.9.234
August 19, 2022 2:14 pm EDT	Enrollment Agreements - [email protected] added by Greg Goins - [email protected] as a CC'd Recipient Ip: 99.190.9.234
October 20, 2022 6:21 pm EDT	Enrollment Agreements - [email protected] added by Greg Goins - [email protected] as a CC'd Recipient Ip: 99.190.9.234
March 6, 2023 12:47 pm EDT	Enrollment Agreements - [email protected] added by - as a CC'd Recipient Ip: 99.190.9.234

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https://tmiky.com/

Audit Trail Serial# 6b2d058d72bb6f16a69309956dfbaf13