Scribd
Upload
44 views1 page

Withdrawal Form - International

The document is an international student withdrawal form for Centennial College. It collects information about the student such as name, student number, address, program withdrawing from, reasons for withdrawing such as academic difficulties or visa denial, confirmation of returning property, and signatures approving the withdrawal. It also requests information for processing any refunds that may be due.

Uploaded by

Nkosana Cusson
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
44 views1 page

Withdrawal Form - International

The document is an international student withdrawal form for Centennial College. It collects information about the student such as name, student number, address, program withdrawing from, reasons for withdrawing such as academic difficulties or visa denial, confirmation of returning property, and signatures approving the withdrawal. It also requests information for processing any refunds that may be due.

Uploaded by

Nkosana Cusson
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

International Students Program Withdrawal Form

Withdrawal for Academic Semester: Fall Semester ABOUT YOURSELF:


Last Name

Blue - International Education Yellow - Accounts Receivable Pink Student Copy Goldenrod Student Relations

Winter Semester

Summer Semester

Student Number:
First Name Middle Name

Address Telephone Number

City and Province Cell Number

Postal Code Email Address

YOU MUST COMPLETE THE FOLLOWING INFORMATION: I WISH TO WITHDRAW FROM THE FOLLOWING PROGRAM: CAMPUS: Progress Ashtonbee HP Morningside Centre for Creative Communications (CCC)

CHOOSE REASONS FOR WITHDRAWAL: Academic Program does not meet expectations Academic difficulty Transfer to other college or university Non Academic Family Health VISA Denial Other:_________________________________

IMPORTANT: you must make an appointment to see either an International Manager or International Student Advisor and receive an approval prior to withdrawal.
PLEASE COMPLETE AND SIGN I have paid in advance for the next semester I am returning next semester I have advised my Academic Advisor / Program Coordinator on Withdrawal Obtain signature from the Learning Resource Centre (LRC) x
LRC Signature I am aware of the withdrawal deadlines listed in the current Important Dates calendar of academic dates, and I recognize that I am responsible for returning any college property that I might have in my possession. I also understand that this information is collected under the legal authority of the College and Universities Act, R.S.O. 1980, Reg, 640, and is used by the College for processing withdrawals. Any inquiries about this authorization may be directed to Enrolment Services, Centennial College.

Yes Yes Yes

No No No

Sign Here: X Student Signature Must be Completed by Agent Requesting Refund on Student Behalf Agent Name : ________________________ Agent No: ___________ Company Name: ________________________

Date:

Must be Completed if Refund is Payable to a Third Party (e.g. Relative, Contact etc.) Name: ________________________________________ Address:_______________________________________ _______________________________________________ Phone No: ______________________________ E-mail: _________________________________

FOR OFFICE USE ONLY

Offer from alternate institution attached VISA denial copy attached Copy of plane ticket attached Third party fees transfer document attached New entrant Returning

International Rep:_____________________ Approved By:________________________ REFUND LESS:_____________________ Date Signed:_________________________

Student is applying from within Canada Student is applying from home Country

You might also like