Course Withdrawal Form

Complete this form in its entirety and click submit. Your academic advisor will contact you at the e-mail address or phone number you have entered for any additional information or counseling. Please review the following information prior to submission:
Refund schedule
Timeline for withdrawal without academic penalty
Extension policy

Contact Info

First Name: *

Last Name: *

Street Address: *

City: *

State: *

Zip code: *

E-mail address: *

Daytime Phone: *

Request

Is this a course or program withdrawal? *

Choose oneCourseProgramBoth

If course, which course(s) are you withdrawing from?:

Advisor Name: (Not sure?) *

Withdraw reason *

Select oneChanging to a different program/degreeDeath in family/related personal reasonsDeath of a close non-family memberDifficulty with class formatFamily illness/related personal reasonsFinancial problemsMilitary deploymentMoving/relocatingNatural disaster or catastrophic occurenceNeed more support from college staffNo longer interested in obtaining a degreeNot enough time to do coursesOther (please provide reason in explanation below)Personal illness/related personal reasonsTransferring to a different institutionUnable to get help when neededUnhappy with instructor feedbackUnhappy with turnaround time on assignmentsWork related problems

Explanation: *

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