Fillable COLLEGE WITHDRAWAL FORM (Talladega College)

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COLLEGE WITHDRAWAL FORM (Talladega College)

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Revised 09/2020
COLLEGE WITHDRAWAL FORM
Student’s Name ____________________________________________________
ID# _________________________
Email _____________________________________________________________
Phone ______________________
Major ____________________________________________________________
Classification _________________
Reason for leaving Talladega College __________________________________________________________________
Please sign below in the appropriate space, indicating that the above student is in good standing or has made
satisfactory arrangements to settle all outstanding responsibilities.
Signature
Date
Comments
Advisor:
Chair/Director:
Dean/Director:
Student Success (Sumner Hall, Room 104):
Business Office (Sumner Hall, Room 122):
Provost/VP of Academic Affairs (Dr. Lisa Long, Sumner Hall, Room 217):
VP of Student Affairs (Dr. Jeffery Burgin, Seymour Hall, Room 102):
Financial Aid (Seymour Hall, Room 11):
Registrar’s Office (Seymour Hall, Room 9):
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COLLEGE WITHDRAWAL FORM (Talladega College)

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Completed 5 July 2021

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