/ UNDERGRADUATECHANGE OFSTATUS FORM
APPLICATION TO CHANGE PROGRAMME OF STUDY/ APPLICATION FOR REPEAT STUDY/ APPLICATION FOR LEAVE OF ABSENCE/ NOTIFICATION OF WITHDRAWAL

Before completing this form, please read the explanatory notes provided.

1.STUDENT DETAILS:

TITLE AND FULL NAME / (FAMILY NAME UNDERLINED) / SIGNATURE: / REGISTRATION NUMBER:
DATE:
CURRENT FACULTY: / CURRENT PROGRAMME OF STUDY: / CURRENT LEVEL/YEAR: (eg Level 1/2/3, Year 1/2/3)
ADDRESS FOR CORRESPONDENCE: / CURRENT QUALIFICATION AIMED FOR: (eg BA, Adv Dip )
TEL NO: / NAME OF LEA/EQUIVALENT SPONSORING BODY

2AAPPLICATION TO CHANGE PROGRAMME OF STUDY/ APPLICATION FOR REPEAT STUDY:

NEW FACULTY: / NEW PROGRAMME OF STUDY: / NEW LEVEL/YEAR: (eg Level 1/2/3, Year 1/2/3)
EFFECTIVE DATE OF CHANGE: / NEW EXPECTED COMPLETION DATE: / REPEAT PERIOD?: YES NO / NEW QUALIFICATION AIMED FOR: (eg BA, Adv Dip )
FULL TIME PART TIME

If your change of Programme of Study is linked to a period of Leave of Absence, please also complete Section 3.

2BUNIT (MODULE) CHANGES ARISING FROM CHANGE OF PROGRAMME/ REPEAT STUDY:

UNITS TO BE DROPPED / UNITS TO BE / UNITS TO BE ADDED
UNIT CODE: / CREDIT VALUE: / RETAINED
UNIT CODE: / UNIT CODE: / CREDIT VALUE: / APPROVED BY:
(please sign)
1 / 1 / 1
2 / 2 / 2
3 / 3 / 3
4 / 4 / 4
5 / 5 / 5
6 / 6 / 6
7 / 7 / 7
8 / 8 / 8
9 / 9 / 9
10 / 10 / 10
11 / 11 / 11
12 / 12 / 12

3.APPLICATION FOR LEAVE OF ABSENCE:

START DATE: / END DATE: / LAST DATE OF ATTENDANCE: / REVISED EXPECTED COMPLETION DATE:

Reasons: please select up to two reasons, by inserting a number in the appropriate box below, where 1 = main reason and 2 = secondary reason (if any). If your request is on medical grounds, a medical certificate must be attached or sent to Dr Helen Grindley, Student Services, University House.

Academic Financial Medical Personal

If your Leave is linked to a change in your Programme of Study, please also complete Section 2

4.NOTIFICATION OF WITHDRAWAL:

LAST DATE OF ATTENDANCE: / Reasons: please select up to two reasons, by inserting a number in the appropriate box below, where
1 = main reason and 2 = secondary reason (if any) for withdrawal.
Academic / Financial / If transferring to another institution tick and complete below:
Medical
For staff use only: / Personal
Deemed withdrawn / NAME OF INSTITUTION:
PROGRAMME OF STUDY:
DATE OF TRANSFER:

5.FOR STAFF USE ONLY: PLEASE SIGN IN THE APPROPRIATE BOXES BELOW TO INDICATE APPROVAL FOR THE REQUEST

AUTHORISING/RELEASING DEPARTMENT(S) [TWO FOR DUAL DEGREE PROGRAMMES] / RECEIVING DEPARTMENT(S) [PROGRAMME TRANSFERS ONLY]
I support the Change of Programme Leave of Absence
Repeat Study Transfer of Institution
I confirm the Withdrawal / I support the Change of Programme Leave of Absence
Signed:
Print Name:
Date: / Signed:
Print Name:
Date: / Signed:
Print Name:
Date: / Signed:
Print Name:
Date:
SPACE FOR ANY ADDITIONAL COMMENTS FROM THE DEPARTMENT/SCHOOL: / Signed:
FACULTY APPROVAL / STUDENT SERVICES DEPARTMENT USE:
AUTHORISING/RELEASING FACULTY:
Signed:
Date: / RECEIVING FACULTY:
Signed:
Date: / MEDICAL NOTE RECEIVED:
SSG APPROVAL:
RECORD AMENDED: / LEA/SPONSOR NOTIFIED:
DEPARTMENT(S) NOTIFIED:
STUDENT NOTIFIED:

May 2007hmg\tpo\cosug

UNDERGRADUATE CHANGE OF STATUS FORM

Explanatory Notes

You should complete a Change of Status form if you wish to:

  1. Change your programme of studyorrepeat a period of study
  2. Take a period of leave of absence
  3. Notify your withdrawal from the University

Please read the guidance appropriate to your situation below, and follow the instructions for submitting the form overleaf.

Before completing the form, you should discuss your proposed course of action with your personal tutor/other staff in your department/school (and where appropriate with staff of your new department).

You may also wish to consult the University’s Careers Service and/or the Union of Students Advice Centre as appropriate. General guidance and information is also available via the Student Services information Desk (SSiD) website on the help and support webpage at

If you are in the UK on a student visa your change of statuswill not be processeduntil you have spoken to a University immigration adviser. To make an appointment, please email: , or visit Student Support and Guidance, Level 6, University House. Please note that the University must report changes in your circumstances to UKBA, including: changes of programme, leave of absence, withdrawal, failure to attend.

Please note that a change in status may have significant financial consequences which you are advised to check before making any decision, e.g:

Change of Degree Programme - if your change of degree programme involves an increase in the total period of study, you are advised to inform Student Finance England (SFE)/other financial sponsor before requesting the change to establish whether any support will be available for this extended period.

Leave of Absence or Repeat Study - if you receive any grant/bursary from a sponsor, you may need to repay part of this; if you repeat any part of your studies on your return, you may not receive support towards your tuition fees for that part of the programme. You will not be eligible to apply for a Student Loan while on leave of absence and you may not be entitled to any state benefits, though you could still apply for financial help from the University. If you are responsible for paying tuition fees and your leave will have an impact on payments made/due, your position will be reviewed automatically by the University (see

Withdrawal - if you receive any form of grant/bursary from your sponsor, you may be required to repay a portion of this, depending on when your withdrawal takes effect. You may also be asked to make earlier repayment of any Student Loan. In addition, if you undertake another higher education course in the future, it is possible that Student Finance England (SFE) will decide that you are not entitled to anypayment towards tuition fees for the new course.

Your change of status may impact on tuition fees paid or due, and you may even be entitled to a refund (see If you are unsure as to exactly how your change of status may affect your tuition fees, please seek advice from the Student Fees Section of Registry Services on 0114 222 1306 or by emailing . Further information is set out in the leaflet Students and Benefits, obtainable from the Union of Students Advice Centre or from their website at

  • Discuss your proposed course of action with your personal tutor/other staff in your department/school (and where appropriate with staff of your intended new department).
  • You may wish to consult the leaflet Changing Your Course or Leaving Altogether obtainable from the Union of Students Advice Centre or from their website at Please note that changes relating to modular degree programmes are not normally permitted after the end of the third week of each semester.
  • Complete sections 1 and 2A of the form, supplying ALL of the information requested. If you are applying for repeat study, give details of the repeat period in section 2A, and tick the repeat year and full-time/part-time boxes as appropriate.
  • If you are registered on a modular programme of study, you must complete section 2B of the form as follows:

a)if you are changing programme during thecurrentacademic session, complete all three columns in order to indicate those units to be dropped from your record, those to be retained (if any) and those units to be added;

b)if you are changing programme next session, complete only the ‘units to be added’ column with those units you intend to study on your new programme;

c)if you are applying for repeat study, complete only the ‘units to be added’ column with those units you intend to repeat. This section may not be relevant if you are registered on a non-modular programme of study.

Note: If you are applying for repeat study (even if on a different programme), you will need to complete Registration. You will not be granted full registration unless you are able to pay the due tuition fees or can show written proof of sponsorship relating to the repeat period. If you are responsible for paying any of your tuition fees and your change of degree programme has an impact on fees paid/due, your position will be reviewed automatically by the University (for more details see

  • Discuss your proposed course of action with your personal tutor/other staff in your department/school.
  • You may wish to consult the leaflets Leave of Absence obtainable from the Union of Students Advice Centre or from their website at Information is also available via the Student Services information Desk (SSiD) website on the help and support webpage at
  • Complete sections 1 and 3 of the form, including all of the dates requested and the reason(s) for your leave of absence.
  • If you are applying for leave on medical grounds, you must obtain a medical certificatefrom the University Heath Service (or another doctor, if you are not registered with the UHS) and submit it along with your completed form. Students in the Faculty of Medicine Dentistry & Health should obtain a medical certificate from the Occupational Health Service. If your leave of absence is on medical grounds, you may only resume your studies if you are certified as fit to do so by the University Health Service (see
  • If your leave is linked to a change of programme of study, you should also complete sections 2A and 2B of the form (see Section 1 of this leaflet for full details).
  • Discuss your proposed course of action with your personal tutor/other staff in your department/school.
  • You may wish to consult the leaflet Changing Your Course or Leaving Altogether obtainable from the Union of Students Advice Centre or from their website at Information is also available via the Student Services information Desk (SSiD) website on the help and support webpage at
  • Complete sections 1 and 4 of the form. Remember to include the reasons for your withdrawal.
  • If you are transferring to another institution, please give details of the new institution in section 4. This is important for student support purposes; if you are Student Finance England (SFE) sponsored you may encounter tuition fee difficulties at your new institution if full details are not provided.

Checklist:

  • Have you signed and dated the form in section 1 and obtained approval signatures from your department/school in section 5?
  • Have you notified Student Finance England (SFE)/other financial sponsorof the change (if appropriate)?
  • Have you attached a medical certificate (if appropriate)?
  • If you are applying for leave of absence or notifying a withdrawal, have you notified Accommodation & Commercial Services, if you are living in University accommodation?
  • Have you contacted International Student Support and Guidance (if appropriate)?

When you are satisfied that the Change of Status form is complete, return it to the Student Services Information Desk (SSiD) in the Union Building(postal address: SSiD, The Union of Students, Western Bank, Sheffield, S10 2TG).

If you need further clarification, please ask at the Student Services Information Desk in the Union Building, visit the Taught Programmes Office on Level 6 of University House, fax us on 0114 2221304, or telephone/email as follows:

Faculty of Arts & HumanitiesEmail: l: 0114 222 1261

Faculty of Social SciencesEmail: (Law)Tel: 0114 222 1292

Email: (Education, TILL)Tel: 0114 222 1325

Email: *Tel: 0114 222 1301

Email: †Tel: 0114 222 1275

* Architecture, Economics, Landscape, Management, Town & Regional Planning

† East Asian Studies, Geography, School of Information, Journalism Studies, Politics, Sociological Studies

Faculty of EngineeringEmail: l: 0114 222 1291

Faculty of Science Email: l: 0114 222 1273

Faculty of Medicine, Dentistry & HealthEmail: l: 0114 222 1326

Thank you for your co-operation, which will assist us in maintaining an accurate record of your studies.

M:/HMG/TPO/Section Handbook/cosug notes February 2011