*provide Expected Graduation Term
Senior
(92+ credits)*
Junior
(60-91 credits)
Sophomore
(24-59 credits)
Freshman
(0-23 credits)
Class Level
Phone
College
Email
MUID
Section 1: Student Information
Student Instructions
1. If this withdrawal brings you to zero credits, you must complete a Complete Withdrawal Form instead of this form.
2. Complete Sections 1 & 2 of this form using a computer.
a. a handwritten form will not be accepted.
b. an incomplete form will not be processed and returned to you for completion.
3. Print the form using the 'Print Form' button.
4. Sign the form in Section 3; a digital signature is not acceptable.
5. Obtain the required signatures in Section 2 & 4.
6. Submit this form to your college office before the deadline as indicated on the Academic Calendar.
College Office Instructions
Make a determination in Section 5, notify the student and scan the form to the OTR via ImageNow.
Note: tuition refunds will be processed according to the University Withdrawal Schedule.
Single Course Withdrawal: Undergraduate
Purpose: Used by Undergraduate students to request to swap one course for another or to withdraw from a single course.
@marquette.edu
Section 2: Course Information
Section 4: Required Signatures
Check and obtain signatures for all that apply
Adviser Signature for students in the colleges of: Arts & Sciences, Education, Engineering, Nursing, Professional Studies
Army/Navy/Air Force ROTC: Signature of ROTC Official
EOP Student: Signature of EOP Adviser
FFP Freshman Student: Signature of FFP Adviser
International Student: Signature of Office of International Education
Athlete: Signature of Associate Athletic Director for Academic Support
DateSignature
Section 3: Student statement and signature
I acknowledge that the above information is accurate and that I understand that the withdrawn course will be listed with a withdrawal grade on my transcript. I understand this withdrawal
may affect my degree progress, financial aid, scholarships, veteran's benefits or other areas, such as health insurance and confirm that I have researched these issues and informed the
appropriate coordinator/staff person before taking this action.
Section 5: College Approval
Approved
Denied
Date of last attendance, if status change (goes from full time to 3/4 time; goes from 1/2 time to less than 1/2 time, etc.)
Signature of College Representative Date
Comments/Exceptions Conditions
Rev 10/2018
Term/Year
Subject
(e.g. ENGL)
Course/Catalog Number
(e.g. 2710)
Section
(e.g. 101)
Instructor
Day/Time Class Meets
Credits
Session
Number of credits remaining after this withdrawal
Name
Last name, First name, Middle name
Withdraw from
Reason for Withdrawal (be clear and concise)
Major
Course Title
