COURSE WITHDRAWAL FORM
Last Name
First
Student Number
This transaction is not official until
received in the Registrar's Office.
Return immediately upon receiving
signatures.
Address:
Phone:
Return immediately upon
receiving signatures.
CRN
Course
Instructor's Signature
Date
Advisor's Signature
** Falling below full-time status may affect your financial aid, housing, and sports eligibility **
Registrar's Staff: ____________
Date: ___________________
R-6 2/94
.