MA Withdrawal Request Form

For a student withdrawing from studies at LCC during a semester, the date of final approval of this request will be used as the last date of studies on the student's record. If the student withdraws before the last day to drop a course, the student will receive a W (Withdrawn) for each course. The grade of W carries neither credit nor penalty. If the student withdraws after the last day to drop a course, the student will receive a grade of WF (Withdrawn-Fail) for each course. The grade of WF carries the same penalty as F. The Student Financial Services Office will determine a student's eligibility for tuition refund after completion and approval of this form.

The withdrawing student must meet all financial obligations (tuition, library, residence hall fees).

Personal information
Name Name First Last
Personal email
Phone
Home address Home address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Study program
Reason for withdrawal
Withdrawal effective date

Withdrawal effective date Immediately End of the current semester
Would you consider coming back to LCC?

Would you consider coming back to LCC? Yes No

Students who plan to return to LCC will receive an informational email about readmission procedure from the Registrar’s office 2 months prior to the upcoming semester to the email indicated above.
If yes, when?
Additional Comments (optional)
IMPORTANT: TRP or Visa will be canceled for international students immediately after a withdrawal is processed.

IMPORTANT: TRP or Visa will be canceled for international students immediately after a withdrawal is processed. By checking this box and typing my name below I indicate my understanding and agreement with the withdrawal, cancelation, financial aid and refund policies
Name (acts as your digital signature) Name (acts as your digital signature) First Last
Date Date / DD / MM YYYY

MA Withdrawal Request Form

MA Withdrawal Request Form

Personal information