Revised 8/22/18
OFFICE OF GRADUATE STUDIES
WITHDRAWAL FROM ALL CLASSES
Student ID#: ____________________________ Date:____________________
LAST NAME
FIRST NAME
MIDDLE NAME/INITIAL
I wish to Drop All Classes for the following reason(s):
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Fall ___ Winter ___ Spring ___ Summer ___ (Please check from which quarters you wish to be dropped.)
ACADEMIC ADVISER
D
ATE
S
TUDENT FINANCIAL SERVICES DIRECTOR
D
ATE
PROGRAM DIRECTOR
D
ATE
D
EAN OF GRADUATE STUDIES
D
ATE
Records Office Use Only
Refund Percentage ___________Data Entry Person ____________Change Student Status ____________Date Received ___________
Total Credits Withdrawn ___________Student Initial ___________Enter Withdrawal Date ___________