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Registry Withdrawal Form

This document is a student withdrawal form from Babcock University. It collects information about the student such as name, matric number, course of study, and reason for withdrawal. It requires signatures from the student, sponsor, head of department, dean, senior vice president, vice president of student development, and vice president of financial affairs to approve and clear the withdrawal. Once completed, the registrar will sign and date the form.

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Akor Emmanuel
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255 views

Registry Withdrawal Form

This document is a student withdrawal form from Babcock University. It collects information about the student such as name, matric number, course of study, and reason for withdrawal. It requires signatures from the student, sponsor, head of department, dean, senior vice president, vice president of student development, and vice president of financial affairs to approve and clear the withdrawal. Once completed, the registrar will sign and date the form.

Uploaded by

Akor Emmanuel
Copyright
© © All Rights Reserved
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
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OFFICE OF THE REGISTRAR

(Exams & Senate Matters Unit)


BABCOCK UNIVERSITY
STUDENT WITHDRAWAL FORM

A. STUDENT DATA:

NAME: ___________________________________________________ MATRIC NO.: _____________


COURSE OF STUDY: _________________________________________________________________
DEPARTMENT: __________________________________________________________________________
SCHOOL: ___________________________________________________________________________
SEMESTER: ___________________________________ ACADEMIC YEAR: ___________________
HALL OF RESIDENCE: _______________________________________________________________

B. STUDENT STATUS:

LEVEL OF STUDY AT THE POINT OF WITHDRAWAL: ___________________________________


NUMBER OF SEMESTERS ALREADY SPENT IN THE UNIVERSITY: _______________________
CGPA AT THE POINT OF WITHDRAWAL: ______________________________________________
CITIZENSHIP AT THE POINT OF WITHDRAWAL: _______________________________________
TO RESUME (SEMESTER & YEAR): ___________________________________________________
STUDENT’S SIGNATURE: ________________________________ DATE: _____________________

C. CONDITION FOR WITHDRAWAL:

REASON FOR WITHDRAWAL: ____________________________________________________________


(1) Voluntary (2) Advised to withdraw by the University Authority

IS THE UNIVERSITY AUTHORITY UNABLE TO REMOVE THE REASON FOR LEAVING (IF
VOLUNTARY)? ‘YES’ OR ‘NO’

SPONSOR’S COMMENTS/CONSENT (IF VOLUNTARY): __________________________________


(Use separate additional sheets if required)
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
SPONSOR’S SIGNATURE: ________________________________DATE: ___________________________

Page 1 | Withdrawal Form Office of the Registrar


D. CLEARANCE:

ALL THE INFORMATION IN THIS FORM MUST BE ATTESTED TO AND CLEARED BY DIFFERENT
LEVELS OF AUTHORITIES IN THE UNIVESITY AND SPONSORS BY SIGNING THE APPROPRIATE
SECTIONS AS FOLLOWS:

1. GUARDIAN/SPONSOR: NAME: ____________________________ SIGN/DATE:__________________________

2. H. O. D NAME: ____________________________ SIGN/DATE:__________________________

3. DEAN NAME: ____________________________ SIGN/DATE:__________________________

4. SVP NAME: ____________________________ SIGN/DATE:__________________________

5. VP, S. D NAME: ____________________________ SIGN/DATE:__________________________

6. VP, F. A NAME: ____________________________ SIGN/DATE:__________________________

E. OFFICIAL USE ONLY:

DATE COMPLETED FORM IS RECEIVED: ____________________ RECEIVED BY: _________________________

CHECKED BY: __________________________________________ SIGN & DATE: ____________________________

______________________________________________
REGISTRAR’S SIGNATURE, STAMP & DATE

Page 2 | Withdrawal Form Office of the Registrar

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