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Lifelong Learning Drop/Withdrawal
 Fall 2008

1.*Student ID Number

 [Look-up Your ID]

2.*E-mail Address

3. Name

 

 

*Last Name

 

*First Name

 

Middle Initial

4. Mailing Address

 

*Street

 

*City

 

*State

 

*Zip

 

Country

(If not USA)

5. Phone Number

 
  Home
  Daytime Cell Work

6.*Courses to Drop/Withdraw from Student Schedule (Fall 2008):
  Please type Course ID & Title. Include CRN if known.
(i.e. MU226ZB Music Appreciation 30775)
a)
b)
c)
d)
e)
f)
7.*What is your reason for dropping or withdrawing from the above course(s)?
 
8.*Signature
I certify that the information submitted on this form is complete, accurate and true and agree to abide by the drop, withdrawal and refund policies of Emporia State University.
Please initial that you have read and agree with the above statement.
IMPORTANT: The effective date of your drop or withdrawal will be the date this form is received. Therefore, refer to the drop, withdrawal and refund policies of Emporia State University and take in consideration any transition times for submitting your request. All requests submitted after business hours, on weekends, or during holidays will be processed and dated the next business day. Business hours are Monday-Friday, 8am-5pm, CST.

Last Updated March 20, 2008