Late Request for Withdrawal from Class(es)

Written documentation supporting your claim of mitigating circumstances must accompany this form. This form will submit your form and documentation directly to the Registrar's Office. Forms and documentation for Late Withdrawal must be received by the following dates:
 

Student ID (EMPLID):

Date of Birth

Student Name:

Street Address

City

State

Zip Code

Phone Number:

Email Address:

Semester: 

Fall SpringSummer

Year

Please select... 2023 2024 2025 2026 2027 2028

I would like to withdraw from:

Please select... ALL Semester Courses SOME Semester Courses

Please provide information below for each course you would like to withdraw from                   

Class ID#

Subject

Class #

Section

Class Title

Last Day Attended

All requests must include both a Letter from the student, and Documentation of Mitigating Circumstances. See full policy for descriptions of acceptable documentation - POLICY NO: 1-10

Upload Letter Here

Upload Documentation Here

By typing your name below, you acknowledge that you have:                                                                              1. reviewed the Late Withdrawal policy, and                                                                                                              2. provided complete and factual information regarding your mitigating circumstances for withdrawal.    Type Full Name Here