Non-Returning Student Verification
If you are not planning to return to Emmaus next semester, please complete the form below.
New Email Address:
I am not planning to return in the:
REASONS FOR LEAVING
Please check your reason for leaving
I have completed my intended program
Financial reasons (ex. loss of financial aid, loss of family support, etc.)
Change of major that Emmaus does not offer
I am transferring to a college that fits me better
Academics (ex: probation, low GPA, not meeting personal academic goals etc.)
Community Standards/Policies (ex: curfew, housing issues, chapel requirements etc.)
Social/Relational Changes (ex. loss of friends, feelings of disconnectedness etc.)
Family/personal reasons prevent me from returning
Please explain in more details the reasons the reasons indicated above:
Do you plan to return in a future semester?
Please explain including the semester you plan to return:
NON-RETURNING STUDENT CHECKLIST
Please read each of the following carefully to understand the check-out procedures.
Student Financial Aid Office,
563-588-8000 ext. 1309 or email@example.com. If you are receiving scholarships, loans, or other financial aid, contact this office to discuss the financial implications of not enrolling next semester, such as repayment of loans and future financial aid, including scholarships.
Student Accounts Office
, 563-588-8000 ext. 2210 or firstname.lastname@example.org. For questions regarding your Emmaus student account, contact this office.
g, 563-588-8000 ext. 3015 or email@example.com. If you are living on campus, you must notify Residence Life to checkout of your room in order to avoid any fines/charges.
, firstname.lastname@example.org. Please return all library books prior to departure to avoid any charges or holds on your transcripts.
Your signature below affirms your understanding of the Emmaus check-out procedures above.
Should be Empty: