Fillable SUNY ERIE OFFICIAL WITHDRAWAL FROM COURSE FORM ** (Erie Community College)

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SUNY ERIE OFFICIAL WITHDRAWAL FROM COURSE FORM ** (Erie Community College)

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SUNY ERIE OFFICIAL WITHDRAWAL FROM COURSE FORM
** Complete and Return Entire Form to the Registrar's Office **
Student Name
Student I.D. Number
Course Title (Name)
Course Number (ex. EN 123)
Course Section (ex. AB, 01, 0B, IC1)
Semester/Year (ex. Fall ‘14)
Campus
Instructor Name
STUDENT SIGNATURE DATE
PLEASE NOTE: Form must be returned within published deadlines to be accepted. Withdrawal from course(s) may affect Student
Financial Aid. Contact the Financial Aid Office for further Information. WITHDRAWAL FROM COURSE DOES NOT RELEASE
STUDENT FROM FINANCIAL LIABILITY.
Office Use Only: Date Processed Initials Distribution: White: Registrar Yellow: Student
Rev. 10/20 RegC Forms.withdrawal.doc
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SUNY ERIE OFFICIAL WITHDRAWAL FROM COURSE FORM ** (Erie Community College)

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Completed 29 January 2021

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