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Course Withdrawal Request Form

Complete this form if you want to withdraw from a single or all courses before the last day to withdraw date. If the withdrawal deadline has passed, the request is not valid. If you want to withdraw from the University completely, please complete the University Withdrawal Form.

The Specific dates referenced in the Statement Section are published in the Official Academic Calendar.

PERSONAL INFO

Please fill out all fields

Last Name:	First Name:

ID# or Last Four Digits of your SSN:

Phone:

Email:

Are you a graduate or undergraduate student?

Please select the appropriate student type.

Residency:

COURSE INFO

What term do you intend to withdraw from?

Please list the courses from which you wish to withdraw. (Course Name, Course Number and Section)

Please state the reason for your withdrawal request.

STATEMENT

There will be NO REFUND from the withdrawal of classes after the drop period. Withdrawal request forms completed after the withdrawal date for the term will not be valid. Please respond in the box below to acknowledge this.

Please type Understood in the following field.

By clicking Submit I authorize the University to act on the enclosed request.

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NON-DISCRIMINATION POLICY

University of the Southwest admits students of any race, color, national and ethnic origin to all the rights, priveleges, programs, and activities generally accorded or made available to students at the institution. USW does not discriminate on the basis of race, color, national and ethnic origin, physical handicap, or sex in the administration of its educational policies, admission policies, scholarship and loan programs, athletics and other university-administered programs.