Ph.D. Late Withdrawal Request Form

Course withdrawals are generally not permitted beyond Week 4 of any given session. Late withdrawal requests may be submitted a maximum of one session after the session in question. If it is beyond that time-frame, the appeal will be denied. If you experienced an extenuating circumstance, please be sure to include all applicable documentation (i.e. medical documentation, obituary, police reports, etc.) along with dates of the incident (if not attached, the appeal will be denied).

If you would like to request a withdrawal from a course that is still within the first four weeks of the session start, please complete the Ph.D. Course Withdrawal Form instead.
Student Name*
Student ID Number*
Student Email*
Phone Number*
Course*
Course Year*
Explain the reason for your late withdrawal request. (If you have since accessed the course in question in Blackboard, please explain in detail why there is activity):*
Documentation to Verify Circumstances (Optional)
Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 25 MB.
By checking this box I am acknowledging that I am responsible for any potential financial implications of this withdrawal.*
- I understand.
First and Last Name*

By entering your first and last name, you confirm that the information you have entered is accurate.
Date
MM slash DD slash YYYY

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Ph.D. Late Withdrawal Request Form