Withdrawal form

Student name:

Email address:

Phone:

Year:

Semester:

Fall

Spring

Summer

Withdrawal start date:

Reason for withdrawal request:

I understand that withdrawing does not alleviate the fulfilling of any financial obligations that I may have to the school and that any balances owed the school will immediately begin incurring interest. I also understand that I forfeit all privilges related to being a student at the school. To take courses in the future I will need to apply for readmission.

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