Course Withdrawal Form
Withdrawal forms must be submitted to the Registrar’s Office by the deadline on the academic calendar which
is published on the website. Please check the deadline prior to completing this form.
Name: _____________________________________________ Student ID #: ________________________
Course Number & Section: _________________________________________________________________
Term & Year: ___________________________________________
Date of Last Attendance (use last login date for online courses): _____________________________________________________
Students will not receive academic credit for a withdrawn course and are encouraged to consult with their
Instructor as well as their Academic Advisor or Program Director to discuss academic progress prior to
withdrawal. Course withdrawals may affect satisfactory academic progress (as defined in the catalog) and/or
academic standing, and may result in the loss of benefits or permission to participate in University activities or
athletics, and may also delay graduation. It is the student’ s responsibility to understand these consequences.
• Are you receiving Military Veteran’ s Education Benefits? Yes* No
*Please notify SCO in Re gistrar’s Office.
By withdrawing from classes you are aware that you may incur a debt with VA and may be
responsible to pay back monies in regards to tuition/fees and BAH. Initial: ___________________
• Are you an athlete? Yes** No
**Signature required from Director/Coordinator-Student-Athlete Support Services.
Student-Athlete Support Services: ____________________________________ Date: ______________
Note: Athletes must maintain full time status—a minimum of 12 credits.
Please return completed form to the Registrar’s Office—students remain registered until the completed form
is received.
Note: If this form is completed and submitted within the deadline and a refund is applicable, the refund will be
based on the date of initial contact with the Registrar’s Office, not the date the student stopped attending the
course.
Student’s Signature: ________________________________________ Date: ___________________________
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Date Received: ______________________
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