Withdrawal Form
Name
First Name
Last Name
Student ID
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Status
Dual Enrollment
Counselor/Teacher Name
First Name
Last Name
High School
Please Select
Edna Karr
Dr. MLK Jr High School
McDonogh 35
Sophie B Wright
St. Augustine
New Orleans Science and Math
John Ehret
Haynes Academy
McMain
Rooted School
The NET
Abramson
West Jeff
Peabody
Sarah T Reed
Thomas Jefferson
Warren Easton
St. Mary's Academy
Haynes Academy
West St. John
Walter L Cohen
East St. John
South Plaquemine
Patrick F Taylor
Active Semester
Fall
Spring
COURSE WITHDRAWAL REQUEST
Configurable list
*
What is the reason for your withdrawal?
Have you already talked to your counselor or teacher?
*
Yes
No
Reminders
All your information can be found in the Future Knight Portal or self-service Banner i.e. student ID number and email address
Students, please know this is only a request! It will be submitted to your advisor/counselor/administrator at your school for final approval.
Signature
Date Signed
-
Month
-
Day
Year
Date
Registrar's Office Use Only
Withdrawn By
Withdrawal Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: