Spring 2023 Student Withdraw Form

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We recommend checking with your Navigator before you fill out this form if you have any questions about withdrawing from class.
Definition: To withdraw means dropping a class without academic penalty. Assigned "W" as a grade.
Directions:
1. Fill out and sign form.
2. Contact Financial Aid finiancialaid@rappahannock.edu if you are a receiving Veterans benefit or Financial Aid benefits. An adjustment to your credits might impact your benefits.

Email *

Important Dates for the Semester

Todays Date *

YYYY

Last Date of Attendance *

YYYY

Student ID *

Last Name *

First Name *

Indicate current term and year *

Spring 2023

Other:

Are you receiving Financial Aid? *

If you (the student) answered yes to any of these questions this may impact your financial aid award. We recommend you (the student) speak to a representative of that department.

Yes

Not sure (Admissions will contact FA)

Are you receiving Veterans Benefits? *

If you (the student) answered yes to any of these questions this may impact your financial aid award. We recommend you (the student) speak to a representative of that department.

Yes

Not sure (Admissions will contact VA)

Include Course Number, Course Prefix, and Section Example: 33498 BIO 101-45A, 39480 ENG 111-D8B *

Is this a mitigating withdrawal (withdrawal after the last day to withdraw from your session)?

Please note: Mitigating circumstances must have been severe, not foreseeable, and/or could not have been reasonably prevented during the time period in question, you will be required to provide documentation.

Yes

Who is signing this form? *

Student

Other:

Please include full name *

A copy of your responses will be emailed to the address you provided.

Submit

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