Central Connecticut State UniversiOffice of the RegistrarLate Course Withdrawal RequestCourse Withdrawal olicytudent may withdraw from a full semester course from the beginning of the 4weekof the seme ID: 896856
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1 Submit the completed form to: Office of
Submit the completed form to: Office of the Registrar, WillardDiLoreto, Room D202Fax (860) 8322250, Email regstaff@ccsu.edu Central Connecticut State UniversiOffice of the Registrar Late Course Withdrawal Request Course Withdrawal olicy tudent may withdraw from a full semester course from the beginning of the 4weekof the semester until the end of the 12 withoutpermission.will receivetheirtranscript week until must present documentation of extenuating circumstancestheir approvals from the the course and the of the department in the course taught. Poor academic performance is not considered an extenuating circumstance. If the request is approved, a “W” will be recorded on the student’s transcript. If a student stops attending and fails to withdraw officially from a course, a grade of “F” will be recorded on the student’s transcript. In all cases of withdrawal, a “W” does not affect the student’s gradepoint averagepproval is at the discretion of the Instructor and Department ChaiA student should continue attending class until approved for withdrawal. *Refer to the University Calendar for withdrawal dates for each semester and for courses meeting fewer than 16 weeks.DEADLINE:fullyapprovedate withdrawalformustreceivedbyRegistrarlater than he ast day of the termPart ne: Student nformation Name________________________________ Student ID#: ____________________________ Part Two: Course Information I request permission to withdraw after the deadline from:Semester & Year: ___________________________ CRN Subject Course # Course Title Credits Instructor Reason(attach documentation ofxtenuating circumstances)____________________________________________________________________________________________________________________________________________________________________________________________Student nature: _________________________________________Date:________________________________Part ThreeRequired Approval Instructor’s Name: Instructor’s Remarks: A late Withdrawal (“W”) is Recommended : YES NO Grade to Date: Date: Signature: Department Chair’s Name: Department Chair s Remarks: A late Withdrawal (“W”) is Approved : YES NO Date: Signature: