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Application for Leave

Student Registration Number

What is your student registration number?

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Semester

Summer Semester 2023

Winter Semester 2023/2024

Summer Semester 2024

Which semester is affected?

Reasons (I am applying for leave for the above mentioned semester...)

1. ...because during the above mentioned semester I have suffered from an illness which precludes proper studying (testified by a medical certificate indicating type and expected duration of illness as well as statement of grounds why proper studying is not possible).

2. ...in order to take on a period of internship required by my studies but which is not integrated into my study programme (attested by a certificate issued by the internship authority [Praktikantenamt]/Examination Office/Dean's Office).

3. ...for a period of study abroad required by my studies (attested by a certificate signed by the university teacher responsible for the exchange programme in the Faculty; in the case of DAAD programmes the international Office of JLU).

4. ...for periods of maternity protection implemented according to the Maternity Protection Act, for claim to parental leave pursuant to § 15 of the Federal Parental Benefit and Parental Leave Act (attested by a birth certificate/a maternity passbook).

5. ...in order to care for family dependants requiring care (attested by a certificate from the dependant's doctor proving that care is required, to what extent and how frequently care is required and that this is being/will be carried out by the student applying for leave).

6. ...on account of membership of a sports squad (A, B, C or C/D squad) called by a top association at federal level in the German Olympic Sports Confederation (attested by a membership certificate issued by the top association. The certificate must clearly state membership of which squad and membership of the German Olympic Sports Confederation).

7. ...on account of participation in academic or student administration as an appointed or elected delegate (attested by a certificate e. g. from the Electoral Office of JLU/of the Dean's Office/of the Student Union [AStA] or similar).

What is your reason?

Explanatory notes on the reasons

Do you have necessary explanations?

Attestation (Please upload the appropriate proof)

When you submit the form, your JLU email address will also be submitted.

Please be sure to note:
For reasons of leave of absence 2, 3 and 7, it is mandatory to upload the signed confirmation note via "Datei auswählen" when applying. You can find the template here.

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