Withdrawal of Application
Withdrawing from: Spring (May)
Program(s) (e.g. Bachelor of Arts):
First Name(s): Last Name:
Student Number: A Email:
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 email this form to the Service Centre at firstname.lastname@example.org.
Office Use Only:
Date Received: SHADEGR Updated: Initials: