FORM: WD2
NOTIFICATION OF INTENTION TO LEAVE THE UNIVERSITY
PLEASE ensure you complete ALL section on BOTH pages AND SIGN this form.
Students should note that they are liable for ALL FEES up to the date that this form has been
correctly completed and submitted to the Student Desk in the Student Centre or emailed to
studentforms@northampton.ac.uk
BEFORE completing and signing this form students should discuss their intention to withdraw
from their studies at the University of Northampton with either their Programme Leader or
School Academic Advisor
Guidance Notes
Our aim is to ensure that you make the right decision and, should you decide to leave the
University, the financial and visa implications of your withdrawal are understood. The
checklist below is intended to help you think about your options.
If you do decide to leave the University, we need some information so that we are able to
inform your tutors and other official agencies (e.g. Student Loans, UKBA etc) who require
records to be amended.
CHECKLIST
Have you discussed your intention to withdraw with your personal tutor/programme
leader and/or an Academic Advisor?
Overseas Students: Have you discussed the implications of withdrawal with the
International Advisors?
Have you considered the possibility of taking a study break?
Note: International Students must consider visa issues with the International Adviser.
If you have got behind in your studies, have you discussed with your course
leader/tutors whether it might be possible to 'catch up'?
If you are experiencing financial difficulties, have you investigated the possible sources
of financial support available – advice from the Financial Guidance Team?

Section 1: Information about you
Name: .................................................................
Student No: .........................
Course: ........................................................Last Date of Attendance: ..................

Section 2: Please read and sign this section
I have read and understand the guidance given on this form, and I have consulted
the Programme Leader/Academic Advisor and understand the advice I
have been given.
I am aware of any financial/visa implications of leaving University studies at this
point in time.
Signed: …………………………………………………………………… Date: ……………………
IMPORTANT: The University has a legal obligation to record
your reason for leaving: so please complete Section 3 overleaf
Withdrawal – Lilac
September 2015
1
FORM: WD2

Section 3 : Your Reason for Leaving the University
Please read through all of the choices listed below and then tick the ONE that is most
relevant to you.
REASON
TO DO WITH
THE COURSE
AND
ACADEMIC
SUPPORT
Not academically prepared for university study
Course content not what expected
Volume of work more than expected
Level of work more difficult than expected
Level of work easier than expected
Course had inadequate resources
Disliked methods of assessment
Lost touch with course and got behind with the
assessment load
Dissatisfaction with teaching on the course
Breakdown of staff/student relationship
Dissatisfaction with support from personal tutor
ENTERED
Starting a job/business (to do with course)
EMPLOYMENT
Starting a job/business (not related to course)
EQUALITY
Faced harassment, bullying or discrimination
ISSUES
Disability/additional needs not met
FINANCIAL
Problems with course fees
ISSUES
Problems with cost of living/cost of accommodation
Unable to face long term debts
Employer sponsorship withdrawn
HEALTH
Health problems arising since starting course
ISSUES
Problems to do with health issues in existence
before starting the course
Pregnancy
WORK LIFE
Dissatisfaction with Northampton as a place to live
BALANCE AND Dissatisfaction with campus and its facilities
ENVIRONMENT Problems with childcare arrangements
Pressure of having to work and study
Unsocial hours of work placements for course
Difficulties travelling to place of study
Difficulties travelling to work placements for course
PERSONAL
Changed long term career plans
MATTERS
Changed employment- course no longer relevant
Family or relationship issues
Isolation/loneliness/didn’t fit in at
university/homesickness
OTHER
Transferring to another institution
Plan to Restart Year
Other Reason Not Listed Above – Please provide details
TICK
ONE
CS01
CS02
CS03
CS04
CS05
CS06
CS07
CS08
CS09
CS10
CS11
EM01
EM02
EQ01
EQ02
FN01
FN02
FN03
FN04
HD02
HD03
HD04
LW01
LW02
LW03
LW04
LW05
LW06
LW07
PP01
PP02
PP03
PP04
TE01
TN01
We may wish to obtain further details about your reason for leaving to help us learn from your
experience. Please tick the box if you DO NOT wish to receive a telephone call or participate in a
survey.
OFFICE USE:
QLS amended
Programme/Module Leaders
Internal notification (incl Accommodation)
International Office for UKBA
Check eligibility for Interim Award
Withdrawal – Lilac
September 2015
2