Withdrawal from the University

Student ID Number

Full Legal Name

Email (Not Your @carolinau.edu Email)

Phone Number

Campus

Degree Program

Advisor_Name

Advisor_Email

Term of Withdrawal

Year of Withdrawal

When would you like to withdraw?

Reason for withdrawal

Are you transferring to another university?

I agree that...

• By filling out this form, I may owe money to Carolina University for tuition and fees. I understand that it is in my best interest to speak with Financial Aid and Student Accounts before filing a withdrawal form.
• By filling out this form, I understand that I will not be able to use campus housing or campus facilities.
• If I am a main campus student, I must speak with Student Services before leaving campus.

Today's Date:

We’re sorry to see you go! Please share your reason for withdrawing—your feedback helps us improve.