TCJ Cancellation/Withdrawal Form

TCJ Cancellation/Withdrawal Form
This form is to be used by currently enrolled students seeking to cancel or withdraw from all TCJ courses. In order to cancel classes and withdraw from TCJ, you must speak with a member of the Student Life Office in person or via phone. You will be contacted within 48 hours of this form being submitted, to set up an appointment. Completion of this form DOES NOT withdraw you from TCJ. You must speak with a member of the Student Life Office before your withdrawal will be processed.

Note: Failure to properly withdraw from college may result in the assignment of FN grade(s) to the permanent record.
Student ID
Student Name*

First NameLast Name
Today's Date*

MonthDayYear
Date
Email*
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Term from which you are withdrawing
Year*
Semester*

FallSpringSummer
From which program are you withdrawing*

TCJ-Main CampusOnline Only
Degree Type:*
Academic Department:*
Arts & Science Academic Program:*
Biblical Studies Academic Program: *
Business Academic Program:*
Education Academic Program:*
Date of last attendance

MonthDayYear
Date
Please indicate the reason for wanting to withdraw:*
Should be Empty: