email: admissions@solano.edu
Admissions & Records: (707) 864-7171
Please review attached instructions for important information about using this form.
This petition will not be accepted without supporting documentation.
Student Information:
Semester: Fall Spring Summer Year: ___________________
Name: ____________________________________________________ Student ID #:_________________________________
CRN:
Instructor Name:
No Show Drop - Faculty signature required (see below)
Excused Withdraw (EW)
Military Withdraw (MW)
Drop Late Without a "W" & Request Late Refund
Drop Late With a "W"
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Course Name:
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Student explanation (required):
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I certify that I have read SCC's policies/catalog and attached instruction page regarding this request.
Student Signature: __________________________________________ Date: ______________________________________
Email: _____________________________________________________ Phone #: _____________________________________
Student Withdraw Petition
A&R - Financial Aid - Faculty Use Only
By approving this petition, I verify as the instructor of record that I did not clear the above named student from my attendance
roster (per Title 5 Section 58004) and that the above named student did not attend any classes within the add/drop period.
Faculty Signature (for NS drop only):___________________________
Date:___________
Approved Denied
Financial Aid Signature:_________________________________
Date:___________
Will impact Will not impact
A&R Processed & Notified Student: _______________________ Date: __________
Approved Denied
INSTRUCTIONS FOR STUDENTS
This petition is used to withdraw from a class if there was an extenuating circumstance and/or events
beyond your
control affecting your ability to complete the class. This petition can no longer be accepted once
a term has ended. If a student wishes to appeal a class after a term has ended, the student must appeal to the
professor using a Change of Grade petition.
All withdraw requests may affect financial aid, which may result in you having to repay the college.
No Show Drop may be requested if student did not attend ANY classes but did not drop prior to class start
date and
Faculty did not drop after start date. NS drops will not be counted toward the permitted number of
attempts, nor will it affect your GPA. Student & Faculty signatures required.
Excused Withdraw (EW) may be requested if student experiences verifiable extenuating circumstances that
will not allow student to complete the class. Documentation is required. EW will not be counted toward the
permitted number of attempts, nor will it affect your GPA. Financial aid may be affected. Student & Financial
Aid signatures required.
Military Withdraw (MW) may be requested if student receives TDY/deployment/PCS orders. A copy of
orders is required. MW will not be counted toward permitted number of attempts, nor will it affect your GPA.
Drop a Class Late Without a "W" & Request Late Refund may be requested only under verifiable
extenuating circumstances (accident, illness, or other circumstances beyond ones control; supporting
documentation required). An appropriate medical provider’s statement on their official letterhead is required
to support medical reasons. Employment related reasons must be supported by a statement from employer
on company letterhead verifying (1) the student's new work hours and (2) the fact that this change in
schedule is a condition of continuing employment or other explanation if applicable.
If you missed the deadline to drop a class without a “W” due to verifiable extenuating circumstances, and the
term has not yet ended, it is appropriate to complete this petition. Student & Financial Aid signatures
required.
Drop a Class Late With a "W" may be requested only under verifiable extenuating circumstances
(accident, illness, or other circumstances beyond control-legitimate, supporting documentation required) may
students drop or have fees refunded after the “W” deadline. An appropriate medical provider’s statement on
their official letterhead is required to support medical reasons. Employment related reasons must be
supported by a statement from employer on company letterhead verifying (1) the student's new work hours
and (2) the fact that this change in schedule is a condition of continuing employment or other explanation if
applicable. If you missed the deadline to drop a class with a “W” due to verifiable extenuating circumstances,
and the term has not yet ended, it is appropriate to complete this petition. Student & Financial Aid signatures
required.
Students receiving Financial Aid must first speak with and obtain a signature from Financial Aid staff in order to
learn of the effects if the petition is approved. In most cases, dropping a class will result in the student having to
repay their aid and/or may negatively affect their ability to get aid in the future.
Students must describe in detail and attach documentation of extenuating circumstances (ex: doctor’s
note, death certificate, military orders, etc.), which are defined as verified cases of accidents, illnesses or
other circumstances beyond the control of the student.
If no documentation is provided, the petition will be denied.
You must file this petition in the same term as the class, unless circumstances render that impossible. Those instances
will be reviewed on a case by case basis.
Return this form to Admissions & Records after obtaining all required signatures and supporting
documentation for final approval. If there are any questions about this form, please speak with the staff at
Admissions & Records.