Course Withdrawal Form

This form is to be used by students to withdraw from one or more courses. However, this form is not to be used to completely withdraw from all registered courses. If withdrawing from all courses, please fill out the Official Hiatus or Withdrawal from the University Form.

Students should complete Sections 1-4 of this form, print it, sign it, have it signed by their academic advisor/success coach, and then return it to the Registrar’s Office after the drop/add deadline but prior to the withdrawal deadline.

SECTION 1: COURSE WITHDRAWAL POLICY

_To withdraw from a course, students must complete this form and submit it to the Registrar’s Office. Students may not withdraw from courses online through WebXpress. Notice to the instructor of intent to withdraw is not sufficient. Students who stop attending and fail to officially withdraw from a class will be given a grade of “FX,” which calculates as an “F.”

Students may withdraw from a course only during the published withdrawal dates. Students withdrawing from a class during this period will have a “W” recorded on their transcript; a grade of “W” does not affect the GPA. The last date for withdrawal from a course without penalty is listed in the academic calendar for each semester. Withdrawing from a course after the published withdrawal date results in a grade of “WF.” Students may not withdraw from classes during exam week.

Traditional students who withdraw from an accelerated course that is offered any time during the semester must do so during the drop/add period, which is the first week of the semester. After the drop/add period ends, students will be able to withdraw based on the published schedule, but no refunds of tuition will be given even if the class has not started.

A student may be administratively withdrawn from the University if his/her absences in a class are excessive.

☐ By checking this box, I acknowledge that I have read and understood the Course Withdrawal Policy.

SECTION 2: STUDENT INFORMATION

Name (Last, First Middle): Click here to enter name. Date: Click here to enter date.

Student ID Number: Click here to enter Student ID number. Advisor/Success Coach Name: Click here to enter text.

Term: ☐ Fall ☐ January ☐ Spring ☐ Summer Year: Click here to enter year.

Enrollment Status: ☐ Full-Time ☐ Part-Time ☐ Non-degree Major: Click here to enter text.

Course Withdrawal Form Office of the Registrar Rev. 6/15/17, Page 1 SECTION 3: COURSE(S) TO BE WITHDRAWN

Subject/Department Course Number Section Number Course Title Click here to enter Click here to Click here to Click here to enter course title. subject/department. enter course enter section number. number. Click here to enter Click here to Click here to Click here to enter course title. subject/department. enter course enter section number. number. Click here to enter Click here to Click here to Click here to enter course title. subject/department. enter course enter section number. number.

Reason for Withdrawal: Click here to enter reason for withdrawal.

SECTION 4: SPECIAL CONSIDERATIONS

Check all that apply:

☐ Student Athlete: I am a student athlete and understand that my eligibility may be affected by withdrawing from this course (dropping below full-time status of 12 credits).

☐ Financial Aid Recipient: I am a financial aid recipient and understand that my eligibility may be affected by withdrawing from this course. I have contacted the Financial Aid Office about this matter.

☐ Residential Student: I am a residential student and understand that my residence eligibility may be affected by withdrawing from this course (dropping below full-time status of 12 credits). I have contacted Residence Life for more information on this matter.

☐ Veteran or Recipient of Veteran’s Benefits: I am a veteran or a recipient of veteran’s benefits and understand that Stevenson University is required to submit changes in my enrollment status to the VA.

☐ Not Applicable: None of the special considerations described above apply to me.

SECTION 5: SIGNATURES

______Student’s Signature Date

______Academic Advisor/Success Coach’s Signature Date To be completed by Registrar’s Office:

☐ Form and received and entered on (mm/dd/yy) ______by ______

Course Withdrawal Form Office of the Registrar Rev. 6/15/17, Page 3