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): ______________
