Lucy College Dire Dawa Program Withdrawal Form
Student Information
Student Name
First Name
Last Name
Contact Number
Please enter a valid phone number.
Email Address
example@example.com
Student ID
Grade
1-4
Programe
Department
GPA
CGPA
Active Semester:
1st Semester
2nd Semester
3rd Semester
Advisor Name
First Name
Last Name
Course Withdrawal Request
Which course(s) or Programs do you want to withdraw?
*
Reasons for withdrawal:
Student Signature
Date
-
Month
-
Day
Year
Date
Submit
Submit
Should be Empty: