Fillable Graduate Withdrawal Form Complete this form and return (New Mexico Institute of Mining & Technology)

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Graduate Withdrawal Form Complete this form and return (New Mexico Institute of Mining & Technology)

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Graduate Withdrawal
Form
Complete this form and return it to the Center for Graduate Studies to withdraw from your NMT graduate program.
Complete the withdrawal from at the Registrar's Office to drop/withdraw from each of your classes.
Grades will be assigned per catalog policy.
Student Name: Student ID: Term:
Permanent Email-Address:
Permanent Mailing Address:
Signature:
Date:
You remain responsible for all charges, tuition, and fees associated with your courses.
Reason for withdrawal (check all that apply and provide additional information below or attach documentation)
Academic Issue: Which
department:
Instructor Conflict: Which
Instructor:
Military Obligation
Work Related Issue
____ Job change/transfer
____ Schedule change/conflict
Financial Aid Issue
____ Lost scholarship
____ Not enough aid
Medical Issue
____ Personal
____ Family
Family Issue
Explanatory Details:
Additional Information or Staff Followup:
Signatures
Department Chair:
Graduate Dean:
Academic Advisor: Date:
Date:
Date:
Student Information
Phone Number:
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Graduate Withdrawal Form Complete this form and return (New Mexico Institute of Mining & Technology)

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Completed 24 August 2020

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