A student may withdraw from any or all courses and receive a grade of “W” after the official withdrawal date ONLY if emergency or
extenuating circumstances exist.
To request a “W” after the final withdrawal date, the student must:
1. Complete this Late Withdraw Request (Please use one form per course!)
2. Complete a Registration Add/Drop form, available online or in Student Affairs
3. Obtain the recommendation & signature of the instructor if available
4. Submit both forms to the Academic Dean
a. A copy of the decision of the Academic Dean will be provided to the student and the instructor.
b. This form and the Registration Add/Drop form will go to the Office of Student Affairs.
Briefly list the emergency or extenuating circumstances, which resulted in your request to drop the course listed on the attached
Registration Add/Drop form and shown above. You may attach supporting documentation.
☐ CRI:R-WITH Processed by ____________
☐ Student File cc: Instructor, Dean Date ____________