<p> WITHDRAWAL FORM</p><p>Student name: ______Student I.D.: ______</p><p>Programme/Course: ______</p><p>Stage/Year: 1st  2nd  3rd  4th  6th  Telephone number: ______</p><p>Note: If you qualify for “free fees”, your decision to leave the course now may affect entitlement to “free fees” when you return to take up studies at this stage of the programme in this or any other third level Institution in the future. Key dates are 31st October and 31st January. See student handbook for details.</p><p>Reasons for leaving the course: Please tick appropriate box(es):</p><p>1. I made the wrong course choice Because of (a) Inadequate career guidance  (b) Inadequate documentation on course content  (c) Other (specify) ______</p><p>2. Course was difficult ……………………………………………….. </p><p>3. Parts of the course were too difficult ……………………………… </p><p>4. Course not what I expected ………………………………………...…………………………………</p><p>5. Poor communications from staff ……………………………………………………………………..</p><p>6. Insufficient academic support ………………………………….…...... </p><p>7. Insufficient personal support …………………………………………………………………….. </p><p>8. Financial reasons ………………………………………………………………. </p><p>9. Took up employment ……………………………………………………………… </p><p>10. Personal reasons not related to the college (E.g. health, family circumstances) </p><p>11. I was not prepared for third level education ……………………… </p><p>12. Commuting time ……………….…………….……………………. </p><p>13. Got offer of a course in another college ………………………….. </p><p>14. Other ………………  (please specify) ______</p><p>Signed: ______Date: ______</p><p>Complete and return this form and your student card to: </p><p>Academic Administration & Student Affairs Office, Dun Laoghaire Institute of Art, Design and Technology, Kill Avenue, Dun Laoghaire, Co. Dublin.</p><p>Form ASA WD 1 updated April 2008</p>