Course Withdrawal Form
Students can withdraw a course before the deadline published in the Academic Calendar for the semester after the refund
period has ended. However, courses that are shorter than the full semester will have different deadlines. Students in these
courses will need to check with their Academic Advisor or the Registrar’s Office for the withdrawal deadline.
Successful withdrawal from a class results in a “W” grade posted to the academic transcript and does not reverse the
student’s responsibility for tuition and fees associated with the withdrawn course(s). Failure to properly withdraw may
result in a grade of “F” begin posted for the course(s).
Students must consult with the One Stop Center and their Academic Advisor to discuss the implication of a course
Course withdrawals are not effective until this form has been submitted to the Registrar’s Office for processing.
First Name: ________________________________ Last Name: _____________________________
Student ID: ________________________ DOB: _________________ Major/Program: ___________________________
Phone Number: ________________________________ Email: ______________________________________________
Course Number (i.e. 1010)
Are you receiving TOPS? Yes ☐ No ☐
Reason(s) for Withdrawal:
☐ Work Related
☐ Cannot continue courses online due to lack of internet access (due to COVID-19)
☐ General reasons due to COVID-19_______________________________________________________________
☐ Other (please explain)_________________________________________________________________________
By signing below I certify that I understand the potential academic and financial implications of submitting this form. I
understand that it is my responsibility to consult with the One Stop Center and my Academic Advisor to discuss future
academic and financial implications. I am requesting to be withdrawn from the courses listed.
Student’s Signature Date
Academic Advisor’s Signature Date
SOWELA Technical Community College does not discriminate on the basis of race, color, national origin, gender, disability, or age in its programs or activities. The following person has been
designated to handle inquiries regarding the non-discrimination policies: Title: Compliance Office, Address: 3820 Senator J. Bennett Johnston Ave, Lake Charles, LA 70616, Telephone No: 337-
421-6565 or 800-256-0483, Email: email@example.com
Registrar’s Office Use Only
Processed by: ___________________
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