Main Campus Exit - Southwestern College

Southwestern College Main Campus Withdrawal

Complete all fields of this form if you wish to exit Southwestern College
Student Information
Name:*

First NameLast Name
Student Id: *
ex: 111-xx-xxxx (if you do not know your ID call the registrar at 620-229-6175)
Mailing Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Personal E-mail:*
Southwestern E-mail:*
firstname.lastname@sckans.edu
Cell Phone:*

Area CodePhone Number
Which of the following apply?*

I am completing the current semester and will not return to Southwestern CollegeI am withdrawing immediately and should be removed from all classesIt is between semesters and I am withdrawing before the next semester beginsI am planning to return to Southwestern within the next yearI am withdrawing due to COVID-19 or COVID-19 related circumstances
Primary Reason for Withdrawing*

Financial difficultyTransfer to another college/universityAcademic concerns (faculty, advisor, major not offered, etc.)Medical (self or family)Family Issues/ConcernsWork/employment concernsCo-curricular concerns (athletics, student organization, performing arts)Decided not to attend college any longer
Signature*

Clear
Date*

MonthDayYear
Date
**The official withdrawal date will be determined by the Registrar’s Office based on the student’s first notification to the College or the effective date whichever is latest.**

Upon submission you will receive a confirmation e-mail with a PDF checklist attached. Please open the checklist and complete the listed items!
Should be Empty:

Southwestern College Main Campus Withdrawal

Student Information