Student Study Leave Request
SELF ASSESSMENT FORM
First name
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Last Name
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Year Level
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Akina Group
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Do you fit the criteria to qualify for study leave?
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• All internal standards offered complete. • Enough credits to have passed Level 1, 2 or 3 prior to study leave.
Yes
No
Do you have enough external credits to pass, if you have not yet achieved Level 1, 2, or 3 with internal credits?
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Yes
No
Unsure
Do you need more time at school to complete internals in order to pass?
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Yes
No
Which three subjects do you need the most support with?
Which three subjects do you need the most support with?
NCEA Level 1
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NCEA Level 2
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NCEA Level 3
*
Comments
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