OFFICE OF THE REGISTRAR
THE UNIVERSITY OF NORTH CAROLINA AT PEMBROKE

Undergraduate Withdrawal Application

 

This form must be completed and submitted online.

Retroactive withdrawal request forms are located in the Office of the Registrar or online at: http://www.uncp.edu/registrar/forms/withdrawal_undergrad.htm

Name:
Student ID Number:
Telephone Number:
Date:  
Street Address:
City:
State:
.Zip:  
Email Address:  

Indicate year term you are requesting to be withdrawn
Fall Semester
Spring Semester
Maymester
Summer Session I
Intra Session I
Summer Session II
Intra Session II
 
 
Reasons for Withdrawal:
Transfer
Relocation
Family Reason(s)
   
Financial Reason(s)
Schedule Conflict
Medical
   


Provide an explanation below for withdrawal.

  

Yes No Cancel my course(s) for upcoming semesters .

The date that you submit this form or the date of notification, whichever is later, will be considered your last date of attendance for financial aid and student accounts purposes. Your financial aid may be adjusted if you withdraw before 60% of the semester is completed. Students accounts will adjust tuition, fees, room and board charges based on a pro-rated basis. (Please see the Office of the Controller.)

Copies of this form are forwarded to the student's advisor, the Dean of Students, the Chief Student Affairs Judicial Officer, Student Accounts, the Director of Financial Aid and the Director of Retention and Advisement.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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