Student Withdrawal

Marked labels indicate required fields.

Student Information

Name

Phone

Present Address 1

Present Address 2

Present City

Present State

Present Zip

Future Phone

Future Address 1

Future Address 2

Future City

Future State

Future Zip

Withdrawal Information

First Enrollment Date

Current Degree Program

Withdrawal to be effective

Are you receiving veteran's benefits? yesno

Are you living in seminary housing? yesno

Do you plan to seek readmission? yesno

If yes, when?
At least two months prior to readmission, students should contact the Admissions Office.

Please state your reasons for requesting withdrawal and outline your plans for the immediate future

Scene @ Southern