Application for Associate Dean's Permission to Withdraw Late

advertisement
Faculty of Commerce
Student and Academic Services
PO Box 600, Wellington
Ph: +64 4 463 5376 Fax: +64 4 463 5360 Email: [email protected]
Application for Associate Dean’s Permission to Withdraw Late
(After the first Three quarters of the teaching weeks)
To:
Faculty of Commerce Associate Dean (Students)
*PLEASE TICK IF YOU ARE AN
INTERNATIONAL STUDENT:
Surname:
First Name(s):
Student ID number:
e-Mail/Postal Address (for reply):
__
Course(s) from which withdrawal is requested:
↓
Course Code
FOR OFFICE USE ONLY
Course Coordinator
Not already failed ()
Approved?
Y/N
Y/N
Y/N
Reason for requesting withdrawal:
The following medical/personal circumstances will prevent me from completing my course(s)
(please specify relevant dates and attach supporting documentation):
Signature:
Date:
Return this form to Faculty of Commerce, Student and Academic Services.
Updated August 2012
Download