Withdrawal of Application
for Graduation
Graduation Information:
Withdrawing from: Spring (May)
Fall (October)
Winter (January)
Program(s) (e.g. Bachelor of Arts):
Student Information:
First Name(s): Last Name:
Student Number: A Email:
Telephone:
Graduation correspondence will be done by mail, email, or phone using information provided by you on Self Service
Banner. Please ensure your contact information is up to date on Self Service Banner.
Student Signature: Date:
You can drop this form in the Service Centre mail slot in the hall to the left of MM108.
Office Use Only:
SGASTDN Notes:
Date Received: SHADEGR Updated: Initials:
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