Fillable COURSE WITHDRAWAL FORM (Talladega College)

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COURSE WITHDRAWAL FORM (Talladega College)

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Revised 9/2020
Student Request
Administrative Action
COURSE WITHDRAWAL FORM
If you plan to withdraw from one or more courses, please complete this form prior to the last day to
withdraw from a course listed in the official academic calendar and submit it to the Registrar’s Office.
Please note that you cannot withdraw from a course if the withdrawal will change your enrollment
status from full-time (12 or more credits) to part-time. Print or type information on sheet unless
signature is requested.
Student’s Name ______________________________________
Student ID# __________________
Email _______________________________________________
Phone _______________________
Major _______________________________________________
Classification _________________
Reason for withdrawal from the course(s) (Use additional paper if necessary):
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Course Designator/Number
Instructor's Signature
Date
___________________
________________________________
_____________
___________________
________________________________
_____________
___________________
________________________________
_____________
Please obtain the following signatures in sequence:
Approve Disapprove Date
Faculty Advisor
Department Chair
Dean/Director
Financial Aid Staff
Student’s Signature ____________________________________________ Date ___________________
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Completed 5 July 2021

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