Policy Agreement for Late Withdrawals – Complete One Form Per Course
A student may request a late withdrawal through the Office of the Registrar when a documented illness or
other extraordinary circumstance prevents withdrawal from a course by the established deadlines.
Failing a course is not an appropriate reason to seek a late withdrawal. Students who are failing a
course should follow the "Repeating Courses" policy stated in the catalog.
Students seeking a total medical withdrawal should contact Health Service or the Counseling Center.
The deadline for submitting a late withdrawal is March 15
th
for the immediately preceding fall
semester and October 15
th
for the immediately preceding spring or summer semester.
Procedures for Submitting A Late Withdrawal Requests
Complete the “Policy Agreement for Late Withdrawals” and “Late Withdrawal Request” forms.
Clearly state the reason that prevented you from dropping by the drop deadline.
The submission of the Late Withdrawal request form does not guarantee that the withdrawal will
be approved.
Obtain recommendation and signature from the instructor of the course and the department chair.
Return the completed forms and supporting documentation (if applicable) to the Office of the
Registrar, 1220 Old Main. You may fax to (217) 581-3412, scan or take legible photo with
phone/tablet and email to registration@eiu.edu.
Upon receipt of the completed forms, the Registrar will determine whether granting of the late
withdrawal is consistent with applicable policy. The determination will be sent to the student’s
EIU e-mail account.
If the student wishes to appeal the Registrar’s decision, upon request, the Office of the Registrar
will forward the Registrar's determination of Late Withdrawal requests to the Appeal Committee,
whose decision is final and not subject to further appeal. Appeals must be requested no later than
one year from the close of the term in which the course was taken.
You will be assessed a non-refundable Late Withdrawal Fee of $25 per credit hour requested with a
maximum of $100 per occurrence. The Maximum is $100, even if you withdraw from multiple
courses at once. The fee will be assessed upon the request of late withdrawal and is applied whether
the withdrawal is approved or denied.
The Late Withdrawal request will not be processed without a signed policy agreement.
Course to be considered for a late withdrawal for: the SP_____ (year) FA_____ (year)SU_____ term.
____________________CRN#____________
Or All Courses for the term ___
I understand that:
Submission of the Late Withdrawal request form does not guarantee the withdrawal will be
approved
My account will be assessed a non-refundable late withdrawal fee as listed above
The Registrar’s/Appeal Committee’s decision will be sent to my EIU e-mail account
Student Signature______________________________ E#__________________ Date______________
(hand written signature is required)
Office Use:
Late withdrawal request fee amount to be added to the student’s account ________________ Revised 4/20/15
Eastern Illinois University Please print clearly or type
LATE WITHDRAWAL REQUEST
Student’s Name: ____________________________________________ E # ______________________________
Contact Telephone #_______________________________
The student should provide an explanation of the extraordinary circumstances or a documented illness that prevented them
from dropping by the deadline. (Fill in explanation and print one copy per course to take to the instructor.)
I am requesting late withdrawal from ____________________________CRN#_______________ taken____________
department/course/section semester/year
Or all courses for the term ________
Explanation of extraordinary circumstances or a documented illness that prevented your from dropping by the drop deadline.
(print clearly or attach a typed statement):
*** If you are seeking a withdrawal for medical reasons, attach a copy of your health record or information from your treating
provider (if other than EIU Health Service or Counseling Center) related to this request. Withdrawals for medical reasons will
be sent to Health Service or the Counseling Center for their recommendation.
Student’s Signature: _____________________________________ Date: _________________________
Instructor Information
Last Date Student Attended: _______________________________
[ ] Never attended this class.
Instructor’s Recommendation:___________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Instructor: _______________________________ _____________________
Instructor’s Signature Date
Chair Recommendation
Chairperson of the department in which the course is offered: (Consultation with the Graduate Coordinator is
recommended for all graduate courses.)
[ ] I support the action to allow a late withdrawal.
[ ] I do not support the action to allow a late withdrawal.
Reason for Recommendation: ____________________________________________________________________________
____________
_________________________________________________________________________________
____________________________________________________________________________________________
Dept Chair: _______________________________ _____________________
Dept Chair’s Signature Date
PLEASE RETURN TO OFFICE OF THE REGISTRAR, 1220 OLD MAIN
Revised 4/20/15
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