Student Withdrawal Survey
Student ID #:Current Address:
Phone Number:Program:
Date:Name: _________________________________ ____________
_______________________________ ____________
_________________________ ______________
Please check the reason that best describes why you are withdrawing from WDT.
__________________
Academic Issues
Attendance Issues
COVID-19 Related
Daycare Issues
Financial Aid Issues
Housing Issues
Incarcerated
Job Offer
Lack of Interest
Legal Issues
Medical
Money Issues
Moving
Transferring Schools
Transportation Issues
Going into Military
Family/Personal Issues
Did Not Return
Quit Coming Unable to Contact
Non-Payment
Other
I plan to return next (check one): Fall Spring Summer Unsure Not Returning
Please write any comments you have related to your experience at WDT.
Student Signature
_
____________________
______________________________________________________________________________________
__________________________________________________________________
______________________
Receiving Vet Education Benefits LDA:Office Use Only: Date of Notification: ___________ _________ Yes/ No
06/2020 Jenzabar Processed (Initials/Date): ______________
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