Fillable Thomas Edison State University University Enrollment Withdrawal Form (Thomas Edison State University)

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Thomas Edison State University University Enrollment Withdrawal Form (Thomas Edison State University)

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Thomas Edison State University
University Enrollment Withdrawal Form
Submit form to: Office of the Registrar
Thomas Edison State University
111 West State Street
Trenton, NJ 06808
registrar@tesu.edu
This form is to be used to notify the University that you wish to completely withdraw your enrollment
and no longer pursue your academic degree program(s) with Thomas Edison State University. Students
who withdraw from the University will lose access to all TESU services including MyEdison, Online
Student Services, your TESU student email account, academic advising and your Academic Evaluation.
Name ___________________________________________________________________________
University ID ___________________________________________
Address __________________________________________________________________
Phone number ______________________________________________________________
Email address ___________________________________________________________________
Enrollment Withdraw reason
Please tell us why you are requesting to withdraw your enrollment at Thomas Edison State University.
❏ Employment ❏ Attending another school
❏ No longer wish to earn degree ❏ Family Obligations
❏ Financial Reasons ❏ Medical
❏ Other: ______________________________________________
Financial requirements
Students who withdraw their enrollment are responsible for and will be billed any outstanding charges
due to the University in accordance with University policy. Transcripts will not be released to students
with any balance due to the University.
Financial Aid Students:
The Financial Aid office will be notified that you have withdrawn your enrollment at Thomas Edison
State University. Your last day of attendance may require a prorated portion of your Federal financial aid
to be returned due to by Federal guidelines. You are responsible to Thomas Edison State University for
tuition and fees not covered financial aid awards. You will receive notification from the Office of Student
Financial Accounts and Operations regarding any balance due once your enrollment withdraw is
processed. Withdrawing from courses may result in the denial of future financial aid because of
unsatisfactory academic progress. Transcripts will not be released to students with any balance due to
the University.
Course enrollment
If you are currently registered for courses, please indicate below the term and courses you wish to
withdraw from in addition to your enrollment withdrawal. If you plan to complete your courses, do not
complete this section of the form.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_________________________________________________________________________________
❏ By submitting this form, you agree that you have read the TESU Enrollment Withdrawal policy and
understand that if you want to return to TESU in the future, you will need to follow University policies in
effect at that time.
Student signature ______________________________________________________________________
Date ________________________________________
We hope circumstances bring you back to TESU!
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Thomas Edison State University University Enrollment Withdrawal Form (Thomas Edison State University)

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Completed 21 July 2020

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