Major:
Withdrawal Semester:
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Fall
Spring
First Name:
MI
Last Name:
Student ID:
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University Email Address:
Telephone:
I hereby withdraw my current enrollment at Western Connecticut State University for the semester indicated above.
I understand that this does not relieve me of any financial obligations to the University.
I have read and understand the University's refund policy as stated on the website at
www.wcsu.edu/cashiers/refund.
Students living on campus are required to contact the Housing Office at 203.837.8531 to withdraw from housing.
A withdrawal could affect your eligibility to receive or maintain financial aid. For more information, contact the Financial Aid Office at 203.837.8580.
I understand that should I wish to return I must reapply through the Admissions office.
Reason for Withdrawal:
Personal
Health
Transfer
Financial
Other
Grades for the Current Semester:
I wish to receive actual final grades for this semester.
I wish to receive W's as final grades for this semester (only if final exam week is not already in session).
If enrolled Summer/Intersession Courses(s):
I wish to receive final grade(s) for course(s).
I wish to receive W’s as final grades for this Summer/Intersession-only if prior to exams.
I am not enrolled in Summer/Intersession Courses
Withdrawals are effective the date this form is electronic submitted.
Comments:
By selecting the "I Accept" button, you are are agreeing to sign this form electronically and that your typed signature is the legal equivalent of your manual signature.
I Accept
Student signature (typed):