Applicationfor Leave of Absence Fromcandidature

APPLICATIONFOR LEAVE OF ABSENCE FROMCANDIDATURE

FOR GENERAL, MEDICAL, PARENTAL OR MATERNITY LEAVE

INSTRUCTIONS TO CANDIDATES:

Please complete Sections A and B in consultation with your supervisory team,then submit the form to your Graduate Research Coordinator (GRC) and Head of School(HoS) to have Section C completed. Once completed, return the form to the Graduate Research Office (GRO) for consideration by the Dean of Graduate Research. Please note, submission of this application does not constitute approval of your request.

Candidates in receipt of a living allowance scholarship may be eligible for up to 84days paid medical leave and/or maternity leave. You will need to refer to the conditions of your award for eligibility.

This application, where possible, should be received by GROfour (4) weeksin advance of needing to take leave. The outcome of your application will be sent to your University of Tasmania (UTAS) email account. Please continue to check your UTAS email account and the iGRad portal regularly.

Please note, information on ‘Support for Candidates with Disability and HealthConditions’ can be found in the procedures and at:

For ALL Requests you will need to include:

• A statement from the supervisory team supporting this application, including implications for timely completion of project milestones and any impacts on supervisory arrangements due to changes in candidature timeframes, and how these will be addressed.

For General Leave of Absence

• Leave of Absence is generally granted after confirmation, or before the last six (6) months Equivalent Full Time (EFT) (for PhD) or three (3) months EFT (for Masters of Research) of your candidature, unless in exceptional circumstances approved by the Dean of Graduate Research.Leave of Absence is generally granted for no more than 365 days (cumulative total)

For Leave of Absence on Medical Grounds

• For personal or carers leave in excess of 10 working days, a medical certificate must be completed by a medical practitioner and submitted with this application. Refer to Clause 3.4.4 and 3.5.2 of the HDR Candidature Management Policy for further details
• If there are circumstances which you do not wish to disclose on this form, you can send a more detailed statement in confidence to the Dean of Graduate Research:

Maternity or Parental Leave

• If applying for maternity leave, please provide proof of pregnancy (e.g. medical certificate or letter from midwife) and expected birth date (or adoption date)
• If applying for parental leave, please provide proof of birth (e.g. birth certificate)

For International On Campus Candidates

• Ensure you discuss this application with an International Student Advisor, as there may be visa/electronic Confirmation of Enrolment (eCoE)implications

NOTE: To add your electronic signature, copy and paste your signature file (JPG, BMP or PNG formats) into the signature box.

SECTION A – TO BE COMPLETED BY THE CANDIDATE

1. Candidate Details

UTAS StudentID:
Candidate Name:
School/Institute: / Choose an item. /
I am: / ☐A Domestic Candidate / ☐An International Candidate
International Candidates Only: I understand that a change to my candidature may have visa and/or eCoE implications AND I have discussed this with an International Student Advisor. / ☐Yes / ☐No
Are you in receipt of a living allowance scholarship? / ☐Yes / ☐No
If Yes, what is the name of the Scholarship?
Do you have an overdue confirmation or annual review of progress milestone in iGRad? / ☐Yes / ☐No
Note: General Leave of Absence will generally not be processed while an overdue item is outstanding

1. Leave of Absence Details

I am applying for a Leave of Absence from my candidature:
Leave Start Date: / dd/mm/yyyy / Leave End Date: / dd/mm/yyyy
Please indicate the type of leave: / ☐General Leave / ☐Medical Leave / ☐Maternity Leave / ☐Parental Leave

1. Candidate supporting evidence

Please provide further details to support your Leave of Absence application, including how any implications for timely completion of project milestones and any impacts on supervisory arrangements due to changes in candidature timeframes will be addressed
If you are applying for a Leave of Absence on Medical grounds, please arrange for your medical practitioner to complete a medical certificate in support of this application. The following statement should be included on your medical certificate:
The candidate’s(orcandidate’s partner or immediate family member’s) illness or incapacity is sufficiently serious to prevent the candidate from working on their Higher Degree by Research for the period start date to end date
NOTE: A candidate statement must be provided for this application to be considered
Candidate Statement (required)
I have included a supporting statement to this application / ☐Yes / ☐No
I have discussed this application with my supervisory team and obtained their support / ☐Yes / ☐No
I have provided all required documentation to support my application (including a medical certificate, letter from midwife or birth certificate where necessary) / ☐Yes / ☐No
NOTE: your application will not be considered if this information has not been included
Name / Signature / Date
Candidate: / / dd/mm/yyyy
SECTION B – TO BE COMPLETED BY PRIMARY SUPERVISOR

1. Supervisory Statement of Support

Please provide details to support this application and ensure you outline, where relevant, that:

• The candidate will continue to have adequate supervision and supportfor their return to work to facilitate the completion of candidature in line with the revised completion plan and/or CMP;
• Implications for timely completion of project milestones and impacts on supervisory arrangements due to changes in candidature timeframes have been addressed;
• The school will continue to have sufficient resources; and,
• Where a candidate’s request is for personal and/or medical reasons, please refer to Supporting and Managing Candidates’ Wellbeing and UTAS Safety, Health and Wellbeing websites for further information

NOTE: A supervisory supporting statement must be provided for this application to be considered
Supervisory Statement (required)
I have discussed this application with the Candidate including support for their return to work and addressed any impacts on project milestones and supervisory implications due to changes in candidature timeframesand I support the request. / ☐Yes / ☐No
Name / Signature / Date
Primary Supervisor: / / dd/mm/yyyy
SECTION C – TO BE COMPLETED BY THE SCHOOL

1. Endorsements

Graduate Research Coordinator
I support this application for a Leave of Absence / ☐Yes / ☐No
GRC Statement (required)
Name / Signature / Date
GRC: / / dd/mm/yyyy
Head of School
I agree that the candidate, supervisory team and the school have the adequate resources for this candidate to complete their thesis within their revised timeframes following the candidate’s return from their Leave of Absence / ☐Yes / ☐No
HoS Statement (required)
Name / Signature / Date
HoS: / / dd/mm/yyyy

1. Submission

Please submit your form to the relevant inbox depending on your affiliated school:

(Sciences, IMAS, AMC)

(Arts, Law, Education)

(Health and Menzies)

(Tasmanian School of Business and Economics)

Leave of Absence Application Form (Version: 20171027)1 | Page