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OfficialWithdrawalfromCollege

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File type: PDF

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Registrar’s Office
115 South Street
Middletown, NY 10940
Official Withdrawal
From College
Section 1: Must Be Completed By Student
Name of Student
Student ID#:
Date:
Address:
Semester
Phone Number
Student Reason For Withdrawing (Check One -- the most prominent)
Employment(New
or Change in Hours)
Financial Aid
(FAFSA Issues)
Transportation
Issues
Military Deployment
Health Issues
Academic Issues
Transferring
Personal Issues
Other
Comments:
I Intend to Return: P/T Semester________ Year_______
Student Signature:
Date:
Section 2: To Be Completed by the Academic Advising Office
Date of Initiation:
Degree Seeking
Non-Degree Seeking
Current Financial Aid Recipient or Applicant? Yes No If (NO) Financial Aid signature not required
Academic Advising Office Signature:
Date:
All Federal financial aid recipients who withdraw or stop attending classes in the first 60% of
the semester will have their federal financial aid recalculated (see College Catalog).
Section 3: To Be Completed by the Financial Aid Office
Current and/or Former Loan Recipient? Yes No Exit Interview done Y/N ____________
FAO Signature:
Date:
All students must complete a DROP/ADD form.
An Official Withdrawal from College form will not be processed without the appropriate signatures and
must be returned to Student Services Central immediately
From the date of initiation in order to officially drop your classes.
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OfficialWithdrawalfromCollege

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Completed 9 March 2020

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