Banner Image
Back to Distance Learning Forms

Course Withdrawal / Drop Form

Your Name: *
Date of Birth: *
(MM/DD/YYYY)
Your Email: *

I wish to drop / withdraw from the following courses in accordance with the Academic Regulations. I understand that if I drop / withdraw from this course after the term's add/drop period, a "Wd" grade will remain on my official transcript.
Reason for Course Withdrawal / Drop:
Course Term/Year: *
Course Code and Section:
Course Title: *
Credits:
Professor Name:
* By checking this box I hereby affirm that this is my official signature indicating my request to withdraw from this course and hereby affirm that no additional signature is required once I check this.