Semester Withdrawing: FALL 20 WINTER 20 SPRING 20 SUMMER 20
Student ID#: Name:
College Email Address: Primary Phone:
Please refer to the Academic Calendar for the nal date to withdraw from courses.
Note: A (W) grade will appear on the ocial transcript for courses from which a student withdraws.
No forms will be accepted after the deadline. Failure to properly withdraw from a course may result in a failing grade.
1. Speak to your Professor (Optional, but strongly recommended).
2. A signature from your Counselor, Faculty Advisor, or Professor is required to withdraw from one or more courses.
If you are taking an online course, we will accept an email from your instructor or advisor emailed together with this form.
3. Are you a Veteran? If YES, meet with your Veteran’s representative prior to withdrawing. Benets may be aected by your withdrawal.
4. Are you receiving Financial Aid?
• If YES, withdrawing from courses may aect your nancial aid and a signature from a Financial Aid Representative is required
prior to withdrawing from one or more courses.
• If NO, only a signature from a Counselor, Faculty Advisor, or Professor is required to withdraw from one or more courses.
Tunxis Community College
COURSE WITHDRAWAL FORM
Completed form (signed and dated) must be submitted to the Registrar's Oce.
Tunxis Community College • 271 Scott Swamp Road • Farmington, CT • 860.773.1300 • tunxis.edu
REFUND POLICY: Refunds are NOT granted for withdrawals.
By signing below, I acknowledge and understand that I am withdrawing from course(s) and I assume nancial responsibility according
to the student refund policy.
Student Signature: Date:
Withdrawal Reason Codes - Providing one or more reasons is optional.
JS: Job Schedule Conict CD: Course Content Diculty LI: Lack of Interest in Course
HM: Health/Medical Issues TM: Too Many Courses TD: Transportation Diculty
FO: Family Obligations/Childcare FD: Financial Diculties PR: Personal Reasons
MV: Moving Away/Relocating NN: Not Needed
Do you plan to return? YES Semester NO
Counselor/Faculty Advisor/ Financial Aid and/or Veteran’s Withdrawal
Course Title or Professor Signature Representative Signature Reason Code(s)