Fillable Course Withdrawal Request Form

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Course Withdrawal Request Form

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The Course Withdrawal Request Form form is 1 page long and contains:

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Country of origin: CANADA
File type: PDF

BROWSE OTHERS (CANADA) FORMS

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Vancouver Learning Network
530 East 41st Avenue Vancouver, BC V5W 1P3
www.vln
s.ca Tel: (604) 713-5520
Course Withdrawal Request Form
Date:___________
Personal Education Number (PEN: 9 digit
numbe
r): ______
___
Legal First Name:_______________________________
Legal Last Name:_______________________________
Legal Middle Name (If you do not have one put NONE):______________________
Preferred First Name:____________________________
Course Name: ___________________________________
Course Section: ________________________________
Teacher: ________________________________
Reason for withdrawing (Select from dropdown):
Is there anything that we can do to help you finish the course instead of withdrawing?
For paper-based courses please return all course materials as soon as possible after withdrawing from the course.
Any deposits on paper-based courses will be refunded once we receive your course materials and deposit receipt.
Select withrawal reason from list below:
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Course Withdrawal Request Form

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Completed 17 April 2021

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