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University Withdrawal Request

Please complete this form if you would like to withdraw from the university. The Specific dates referenced in the Statement Section are published in the Official Academic Calendar.

Personal Info

Please Fill Out Each Field

Last Name:	First Name:

ID# or Last Four Digits of SSN:

Phone:

Email:

Are you a graduate or undergraduate student?

Please select the appropriate student type.

Residency:

*Please state your reason for your university withdrawal request.

STATEMENT

I understand that by completing this form, I will be withdrawn from all courses and the university. If I wish to attend future terms, I will need to re-apply to the university. There will be NO REFUND from the withdrawal of classes and/or the university after the drop period. 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.