Complete form if withdrawing from a course or completely withdrawing from CPTC.
Complete form and return to Registrar's Office for processing.
ID/SSN# Today’s Date
Last Name First Name
Email Phone Number
Note: Students who attend class but FORMALLY withdraw from a course by the end of the third business day of the term
will receive no grade for the course and will receive 100% refund of applicable tuition and fees and Financial Aid Awards
will be adjusted accordingly. Students purchasing books using Financial Aid awards and subsequently dropping courses
will be responsible for charges if financial aid award is reduced.
Students who withdraw from a course after the end of the third business day of the term shall receive a grade of 'W'
and shall receive no refund of tuition and fees.
In order to receive 100% refund, this form must be completed BY THE STUDENT and submitted to the Registrar's Office
by the end of drop/add period.
CRN Subject Course# Last Date Attended Instructor Signature
Students dropping online courses must attach an email acknowledgement from instructor noting the
students' intent to drop.
Withdrawal from CPTC may reduce your Financial Aid award and affect Satisfactory Academic Progress.
Grades for withdrawals are W.
It is the student’s responsibility to verify financial aid adjustments with Financial Aid office.