Intent to Discontinue Studies
This form is for students who are not planning to return for the following term in which they are currently enrolled.
Completion of this form will result in removal from any classes in which preregistration has been processed. This
form should be returned by ema i l to firstname.lastname@example.org, fax (304-473-8531), or mail (59 Col l ege Avenue,
Buckhannon, WV 26201) or in person.
PLEASE PRINT CLEARLY
I, ____________________________________ wi l l not be returni ng for the ____________s emester due to the
(Full Name ) (term/year)
following reasons (please check all boxes that apply to your situation):
I am transferring to ________________________________________
I prefer a di fferent program of s tudy (Pl ea se s tate ___________________________________)
I prefer to be clos er to home
I will be completing remaining graduation requirements elsewhere
Other – please specify ____________________________________________________________
Please remove me from any classes for which I have preregistered. I understand that offices will be notified of my
intent and I will need to settle my affairs with the Office of Student Accounts, Financial Aid and Student Life.
Student Signature ________________________________________ Da te ________________________
Student ID# _________________ Emai l ___________________________________________________
Phone# ________________________________ Are you preregi s tered for the next semes ter? Yes ____ No ____
(For Office Use)
Received by: ____________ Da te: ____________ Proces sed Date: ____________