Official Withdrawal from College
1.
2.
3.
Students must meet or speak with their academic advisor to discuss their intention to withdraw from SUNY Cortland.
If a student is receiving financial aid, including student loans, they are required to meet or speak with a Financial Aid advisor
to understand financial obligations, and any potential financial or eligibility impact a withdrawal will have.
Students must submit this form to the school Associate Dean for approval. The Associate Dean’s Office submits the form to
the Registrar’s Office for final processing.
Student Name:
Cortland ID Number:
Permanent Address:
Telephone Number:
City:
State:
Major:
☐ BA ☐ BFA ☐ BS ☐ BSED ☐ MA ☐ MAT ☐ MS ☐ MST ☐ MSED ☐ CAS ☐ UND
School:
☐ Arts & Sciences (Submit to OM 125)
Zip:
Registrar’s Office
E-mail:
☐ Education (Submit to EDUC 1239)
☐ Professional Studies (Submit to PFST 1175)
Associate Dean approval is REQUIRED. Please read and complete all of the required steps below.
1.
Financial Obligations: Pursuant to New York State law (302.1, Title 8), students with outstanding financial obligations to the College are
denied transcript service, readmission, registration and other college services. Financial Liability will be based on the effective date of the
withdrawal. Please review the Student Accounts site for complete policies and state regulations.
2.
Deadline: To be effective in a current semester, a withdrawal must be submitted to the associate dean of the school in which the student
is enrolled by the last day of classes.
3.
Grades: A withdrawal grade (“W”) is assigned to each course in the semester in which the student withdraws from SUNY Cortland unless
the instructor has assigned a course grade. Finalized grades will not receive a withdrawal (“W”) grade. This includes graded quarter courses.
4.
Reason(s) for withdrawing from SUNY Cortland
Please rank the top three reasons, with 1 being the most important reason.
___ Academic difficulty
___ Medical
___ Courses not offered / available
___ Moving / relocating
___ Dissatisfied with SUNY Cortland environment
___ Personal / family factors
___ Dissatisfied with Support Services
___ Program / major not offered or available
___ Employment
___ Return Home (academic, financial and/or geographic reasons)
___ Financial
___ Transferring to another college:
___ Military
School
5.
Financial Aid Signature:
6.
International Programs Signature:
7.
Comments:
8.
Student Signature:
Major
Date:
or ☐ No Financial Aid
Students receiving financial aid are required to speak with a Financial Aid advisor when withdrawing.
Date:
Exchange students or students attending study aboard programs must obtain a signature from the International Programs Office when withdrawing.
Date:
By signing, the student affirms they understand the withdrawal policies, and they have reviewed the notices and policies on the SUNY Cortland site, the
Registrar’s Site and the Student Accounts site.
Associate Dean Signature:
Date:
Effective Date of Withdrawal:
☐ Process as Regular Withdrawal
Hold for end of semester: ☐ Yes
☐ No☐
☐ Process as a Medical Withdrawal (Documentation Required)
Registrar: __ ASC __ Student Accounts __ Financial Aid __ Residential Life
Assoc. Dean: 1) retain copy 2) copy to student 3) copy to major department
Miller Building, Room 223 • P.O. Box 2000 • Cortland, NY 13045-0900 • Phone: (607) 753-4702 • Fax: (607) 753-2959
Rev 1/2015