Course Withdrawal Form

Course Withdrawal Form
Full Name (Legal Name)*

First NameLast Name
Student ID #*
Year*
Request Term*
**PROVIDE THE CORRECT TERM AND YEAR
READ CAREFULLY

Please enter only the classes you are taking this current quarter.

Example:
- SOC 103 / Sociological Foundations
- CRML 120 / Comprehensive Classification
- BUS 150 / Globalization and Effective Communication
OR

If you are on vacation for this current quarter, please type the correct quarter, year, and vacation:

Example:
- WINTER 2026 VACATION
Please do not enter “ALL” or “I don’t know.”

It is the Student’s Responsibility to enter all course names correctly.
Course Number and Title*
By Signing below, I am confirming my request to withdraw from the courses listed above
Signature of Student*

Clear
Signed Date*

MonthDayYear
Date
Should be Empty: