Fall 2018 Drop Form
• This form will not be accepted before the fourth week or after the twelfth week of classes.
• Per campus policy (SP 13-10), withdrawal before the fourth week is handled by the student (using the myCI portal) without instructor
permission.
• Beginning the fourth week of the term, dropping a class is permissible only for serious and compelling reasons, such as illness, accident,
death in the family, financial hardship, or military duty. Reasons that are not considered serious and compelling include course workload,
neglecting to drop the class during the first three weeks, failing an assignment, or change of major.
• The withdrawal will be noted as a “W” on the transcript.
• After week twelve, withdrawal is not permitted except in cases beyond the student's control such as accident or serious illness and will
typically involve total withdrawal from the University; students should use the term withdrawal form.
Student Instructions for Dropping a Class During Weeks 4 through 12 of the Semester:
1) Obtain instructor and program chair signature (e.g. Math chair for a Math class).
Obtaining these signatures does not guarantee
processing of drop request. All requests must comply with campus policy.
2) Enter the reason on the form and provide supporting documentation to verify the reason given.
Your drop will not be processed if you
fail to submit supporting documentation. All requests must comply with campus policy.
3) Sign and date the bottom of the form.
4) Submit completed form and documentation to the Enrollment Center, first floor, Sage Hall. The last day to drop a class is the end of
business on Friday, November 16, 2018. NOTE: Forms placed in the drop box after business hours on 11/16 will not be processed.
**Be sure to check Enrollment Center hours before arriving at Sage Hall**
First Name __________________________ Last Name _______________________ Student ID _____________________
Phone _____________________________ Email_______________________________________________________________
Number of enrolled units before change _________ Number of enrolled units after change _________
Please give reason for drop (weeks 4-12). Attach supporting documentation.
Student Signature __________________________________________________ Date _____________________
Office Use Only- Records & Registration
Processed by (Staff Initials): ___________ PS Update (Date): __________ In Housing? Y / N Student Notified (Initials & Date): __________
Class
Number
Subject
Course
Number
Section
Number
Units
Instructor Signature
Date
Program Chair
Date
1234
MATH 100 02 3 Example
Example
Records and Registration
One University Drive
Camarillo, CA 93012
