Below are the financial consequences of withdrawing:
Fall and Spring
Withdraw from a course on or before*
Tuition
Owed
The 2
nd
Tuesday of instruction
Classes not on academic record
0%
The completion of 20% of term
Classes not on academic record
50%
AFTER completion of 20% of term
Classes on academic record with “W”
100%
Semester & Year
FALL ____________
SPRING __________
_________
Hours BEFORE Change: ____________ Hours AFTER Change: ___________
• Fees will be owed for all withdraws as of the 1
st
day of
instruction
• This form is to be used when making registration
changes outside of the normal registration period
• To withdraw from your last class with UH Hilo use the
Complete Withdraw Form
• Registration changes will be made upon completion
and submission of this form to the Office of the Registrar
Cashier & Registrar Office Use ONLY:
PAID: ________________________ SFAREGS: ___________________ VA Updated: 3/18
CREDIT CARD PAYMENT FORM
CARD HOLDERS NAME: ___
__________________________________________________________________________________________________________
VISA DISCOVER
JCB
CREDIT CARD NUMBER:
EXPIRATION DATE:
__________________________________________________________________
MASTERCARD ________________ CVV2 CODE: _______________________________________
(3-Digit code on back of card)
DOLLAR AMOUNT: $_
______________
CARD HOLDER'S PHONE NUMBER: _
________________________________________________
BILLING ADDRESS: __
________________________________________________________________________________________________________________
STREET
__
___________________________________________________________________________ ___________ ________________________
CITY STATE ZIP CODE
CARD HOLDER'S SIGNATURE: _________________________________________________________________________________________________________
(By signing this payment authorization form I acknowledge that this fee is non-refundable and non-transferable.)
OFFICE OF THE REGISTRAR
UNIVERSITY OF HAWAI’I AT HILO
200 WEST KAWILI STREET
HILO, HI 96720-4091
LAST FIRST (M.I) STUDENT ID
___________________________________________ _____________________________@hawaii.edu
PHONE EMAIL ADDRESS
___________________________________________________________ _______________________
STUDENT SIGNATURE DATE
SUMMER
Register Withdraw CRN Course Alpha/Number Instructors Signature Date
College Dean/Director Use:
*Change of Registration forms will be reviewed on a case-by-case basis.
Each dean has the right to deny a late withdrawal within their College.
College Dean / Director Approval:
*Sign for Approval
For Summer Session refund dates refer to https://hilo.hawaii.edu/depts/summer/lookup.php with CRN.
Information provided here for convenience and does not constitute an official declaration of UH Policy. For
official schedules, please refer to: http://hilo.hawaii.edu/uhh/bo/TuitionandFeeRefunds.php and
http://hilo.hawaii.edu/registrar/currentterm.php. *Deadlines effective Fall 2018
NOT exempt:
Change fee exempt:
CH
ANGE OF REGISTRATION FORM
