Request for Late Withdraw

Request for Late Withdraw
Use this form to request a late withdraw from a course due to circumstances beyond your control. Requests must be made on or prior to the end of the term in which the course was taken. Note: courses dropped will be reflected on your academic transcript with a status of W. Withdrawing may have unintended consequences for you as a student. Before making this change it is recommended that you:
- Meet with your faculty advisor or success coach
- If you are receiving federal or state financial aid, you are encouraged to speak with a financial aid specialist.
- Those receiving veteran's tuition assistance should speak with BMCC's certifying official.
Name

First NameLast Name
BMCC ID
Email
example@example.com
STEP ONE: Indicate reason for request Note: Please provide supporting documentation for your request (below).
STEP TWO: Indicate which course or courses you want to be dropped from. Must provide Couse ID, Section # and Course Title. (e.g.: MTH070 PEND1 Elementary Algebra)
OR
Upload supporting documentation:

Cancelof
By completing this form, I hereby understand and consent to be dropped from the course/s indicated above; and understand and agree that students, parents, or legal guardians will be responsible to pay all charges (including collection costs) incurred if the non-paid tuition and fees are referred to an outside collection,
Student Signature
Date

MonthDayYear
Date
Blue Mountain Community College is an equal opportunity educator and employer
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