Withdrawal from College

Completion of this form documents my intent to withdraw from the College. Any official withdrawal from the College after the last date to withdraw from a full-semester course (with a “W” grade) has passed shall be considered effective the first day of the following semester for academic reasons, and the student will be held academically accountable for the entire semester. Students who have officially withdrawn from the College may apply for readmission.
Student ID#*
Name*
First Middle Last
Address
Street Address Address Line 2 City State ZIP Code
Email*
Enter Email Confirm Email
Telephone #
Academic Program(s)
Semester*
- Fall
- Spring
- Summer
Year*
This form does not withdraw you from your courses. You must log in to SIS to drop or withdraw from your courses. If it is after the 60% point of a course you may also need to submit the WP/WF Form for each course.
Reason(s) for Withdrawal
- Financial
- Work
- Health
- Relocating
- Personal
- Transferring to Another College
- Other
If transferring, to which college are you transferring?
Student Signature*
Date*
MM slash DD slash YYYY