Leave Request

Halcyon Leave Request

This Leave Request is for Halcyon Hall Residents only. Submit your leave request electronically. Leave request information can be located in your student handbook on pages 58-59

Name*
First Last
Mobile Number*
Email*
Enter Email Confirm Email
Your Age*
Please enter a number from 10 to 75.
Your Room Number*
Please select your academic level*
Curfew Level*
Request (Check all that apply)*
- Late (1 hr.)
- Overnight (24 hrs)
- Weekend
- Extended
Purpose*
Host/Place Name*
Address
City State / Province / Region ZIP / Postal Code
Host/Place Phone Number*
Transport Mode*
Driver*
In Company With
Departure Date*
Departure Time*

: Hours

Minutes

AM/PM
Returning Date*
Returning Time*

: Hours

Minutes

AM/PM
Approval does not constitute an excuse from worship, class, work or restriction. In an emergency, which will cause you to be late, you must call into the dean before you are late. Leaves will not be viewed during Sabbath hours. Submission of this request does NOT constitute an approval I affirm that all information on this leave request is truthful and honest