Withdrawal Form Withdrawal Form This form is used to withdrawal from all classes within a current term and/or from the university. Student ID #*Are you withdrawing from more than one term?*YesNoSelect Terms* Spring Summer Fall Select Term*SelectSpringSummerFallTerm's Year*Withdrawing from the program and all classes for the appropriate term checked. The OFFICIAL date of withdrawal is determined by the date that the first contact is made by the student to initiate the withdrawal process. Charges and/or refunds to the student's account and grades are based on this date.Select Program*SelectAdultTraditionalExecutive ProgramMastersDoctorateReceiving TA/VA Benefits (Military)*YesNoName* First Last Last Date of Attendance***Participation is defined as engaged in an academically related activityAddress* Street Address City State / Province / Region ZIP / Postal Code Contact Number*Email* Enter Email Confirm Email Reasons for Withdrawal*Signature* I agree that the above information is accurate, and that I am the student whose name appears on this formCAPTCHA Form has been tagged under:Registrar Skip back to main navigation