Graduate Withdrawal from the College

First Name

Last Name

Student ID

Program of Study

Adviser

Are you enrolled in coursework in the current semester

If YES, will you complete your coursework or withdraw by deadline?

Effective date of withdrawal

Reason(s) for Withdrawal (If more than one reason, select the one most applicable):

Please explain

Additional Comments

I understand that I am withdrawing from Hood College and that if I want to return to my current program of study within the 7-year time limit of my initial enrollment, I must submit a readmission request form.

I accept these conditions.

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