Member Leave Request Form

neXco offers two types of leave request:

  1. Pass on Accountability Requirements – 12 weeks max, where the member is still attending meetings, but needs grace on the requirements due to extenuating circumstances. A members renewal date does not change. 
  2. Leave of Absence – 6 months max, where a member needs to stop attending meetings and stop reporting activity.  A members renewal date will change. 

Leave of Absence / Quarter Pass

Name of member going on leave*
MM slash DD slash YYYY
MM slash DD slash YYYY
Name of leader submitting request*
If you feel comfortable sharing please let us know the reason for this leave request. While the decision to approve a leave request is up to the chapter leadership team, we at neXco Corporate want to ensure our members are supported and feel the warmth of our community during any hardships your members are experiencing.
This field is for validation purposes and should be left unchanged.