Not Returning Students

This form should only be completed if you are planning to complete the current semester and not return for the next semester. If you are planning to withdraw mid-semester, please contact your Academic Advisor for the Official Institutional Withdrawal Form.

Name *

First Last

Student ID *

Home Address *

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone *

Email *

Commuter or Resident? *

Commuter
Resident

Room number *

Not returning for term *

Date leaving *

Future plans to return? *

Yes
No

When do you plan to return? *

Reason (check all that apply) *

Where are you transferring? *

Where is your employment? *

Please describe "other": *

Other notes

Academics – Not Returning Students