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  Home > Academics > Registrar > Forms and Applications > Withdrawal Form

Withdrawal Form

Instructor approval with last day of attendance must be submitted before this form may be processed. An e-mail from the course instructor to the Registrar is acceptable.

Withdrawals will be processed the day this form and the faculty approval are received in the Office of the Registrar. refunds, if appropriate, will be based on the day the withdrawal is processed. There is a $20 per transaction charge.

Name:
Email:
SSN:
Semester and Year:    
Course Name: CRN:
Course Name: CRN:
Course Name: CRN:
Course Name: CRN:
Course Name: CRN:
Is this a complete withdrawal from college this semester? No   Yes
If yes, upon completion of withdrawal Perkins borrowers must schedule an Exit Interview with the Bursar.
Why are you withdrawing?
Are you planning to return?

By submitting this form I state that I understand that I will receive W grades in the courses from which I am withdrawing. I also understand that I must complete this form, obtain authorization (which must include the last day of attendance) from the course instructors and submit both to the Office of the Registrar for processing.

In addition, I have read and understand the "Financial Aid Procedures for Withdrawals" in the current college catalog and the effect of withdrawing from courses on my financial aid eligibility.

 

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Accounting B.S.

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Adolescence Education(7-12)- Biology (BA,BS)

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Adolescence Education(7-12)- Mathematics (BA,BS)

Adolescence Education(7-12)- Social Studies BA

Adolescence Education(7-12)- Spanish BA

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Childhood Education with Bilingual Extension (1-6) B.S.

Comparative Humanities B.A.

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Health & Society B.S.

Industrial & Labor Relations (B.A., B.S.)

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Middle Childhood Education (5-9) - Biology B.S.

Middle Childhood Education (5-9) - Chemistry B.S.

Middle Childhood Education (5-9) - Mathematics B.S.

MiddleChildhood Education (5-9) - Spanish B.S.

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Spanish Language, Hispanic Literature & Culture B.A.

Special Education & Childhood Education (1-6) B.S.

Special Education with Bilingual Extension (1-6) B.S.

Visual Arts B.A., B.S.

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