Be able to do a drop from a course. Make comment area bigger. Withdrawal Request Form

Graceland Withdrawal Request Form

Please complete a separate Withdrawal Request Form for each student.
Every field must be completed.
Contact Cathy Porter with any questions.
If you are enrolled on the Lamoni campus, you should not use this form. Contact the Student Life office at 641-784-5494.

This form will email Cathy to initate the Withdrawal Process.

Withdraw from: Course Program
Your name:
Email address:
Student name:
Address:
 
City:
State:
Zip:
Phone:
Student ID:
Effective Date of Withdrawal (Last date attended classes):
Reason for Withdrawal:
Notification Method
for Withdrawal:
Course Number:
Year: session:
For Program W/D: Immediately End of Session