This form is for F-1 students and J-1 scholars ONLY. Please inform ISSS before you leave the U.S. so we can update our records and your SEVIS record appropriately. Failure to keep ISSS informed will result in an invalid visa status. This form should only be used if you will be away from ODU for less than five months. If you will not be coming back to resume your academic program, please submit the Program Departure Form instead.
Current Visa*F-1 J-1 Other
Academic Level*Bachelors Masters Ph.D.
Anticipated Departure Date*
Anticipated Return Date*
What will your address be while you are out of the U.S.?*
Reason for Leave of Absence*
Additional Information (Please use this box to provide the reason for the last option above and any other details you feel are necessary.)
Important Information for F-1 Visa Holders Only