Excused Withdrawal Form– COVID -19 Spring 2020 Semester
Students who are currently registered in courses beyond March 13, 2020 and wish to withdraw from a course(s) due to the impact of
the novel coronavirus, COVID-19, may submit this form to: Admissions@sbcc.edu . This form will only be accepted if sent from your
official SBCC Pipeline email.
Students are asked to very carefully consider if withdrawing from a class is truly in their best interest. Understandably, tensions
and anxiety is high, but do consider potential consequences, such as: reaching your educational goal, health insurance, and
other unintended consequences.
Before submitting this request, please talk to your instructor about challenges you may experience with remote learning. Your
instructor may be able to identify alternatives conducive to your learning and provide resources to assist you with completing
the course.
What is an Excused Withdrawal? The student’s transcript will reflect an EW symbol indicating an Excused Withdrawal was
awarded for the course(s). This means that the student withdrew from courses due to specific events beyond the control of the
student affecting the student’s ability to complete the course(s).
Excused Withdrawals do not count negatively towards the student’s academic or progress standing.
Will I receive a refund? Yes. Under normal circumstances, per Title 5, section 58508, refunds are not allowed after the first
two weeks of instruction, or ten percent point of the length of the course. However, regulatory authority has been granted to
SBCC via the Chancellor, to waive this provision and grant a refund of enrollment fees ($46 per unit) for any students who
withdraw after March 13, 2020 due to the coronavirus outbreak. All mandatory, optional and nonresident fees will not be
refunded unless the college took action to cancel the course or drop a student who fails to meet a prerequisite. If these fees
were covered by the SBCC Foundation through the Promise Program or waived through the CCPG program, they will be
returned to those programs, not to the students.
Is there a deadline to make this request? Yes. Students are highly encouraged to submit this request prior to the end of the
spring semester, however, students will have one full calendar year after the completion of their course(s) to submit this
request. Please allow 2-3 weeks for your request to be processed by Admissions.
All refunds will be processed automatically; Allow 4 - 6 weeks for processing.
Last Name:
First Name:
Student ID:
Pipeline email:
Today’s Date:
Date of Birth:
Are you a Financial Aid Recipient: ☐Yes ☐ No
Are you attending SBCC under an F1 Student Visa? ☐Yes ☐No
Please list the course(s) you are requesting an Excused Withdrawal from:
Course Title Number Instructor
________________ ____________ ___________________________________
________________ ____________ ___________________________________
________________ ____________ ___________________________________
________________ ____________ ___________________________________
________________ ____________ ___________________________________
By signing below, I certify under penalty of perjury that all information I provided on this petition is legitimate and accurate. My
Excused Withdrawal was necessary because it was difficult or impossible for me to attend one or more courses beyond March 13, 2020,
because I was actively engaged in responding to, or impacted by, the novel Coronavirus, COVID-19.
Signature ___________________________________________________________ Date _______________________________