Complete Withdrawal Form - University Registrar

This form is for traditional undergraduate students that take courses on the Fort Wayne campus. If you are an online student or take courses at another Indiana Tech location, please contact the Warrior Information Network to drop courses from your schedule.

Tuition adjustments will be granted on a specific schedule each semester for students who find it necessary to completely withdraw from the university before the end of the semester and who make prompt official application for withdrawal and tuition refund. You can see the schedule at financialservices.indianatech.edu. Complete withdrawal from the university must be initiated by the student. The withdrawal process begins by completing this form, after which you will be contacted by the Office of Student Success to finalize your withdrawal. Withdrawing from Indiana Tech after the withdrawal deadline (see academic calendar) is permitted, but will result in final grades of F instead of W.

Personal Information

Name*

First MI Last

Student ID*

Cohort*

Semester in which you first enrolled at Indiana Tech

Residency status*

Commuter
On-campus resident

Residence Hall*

Major(s)*

Withdrawal

Academic term of withdrawal*

Fall term
Spring term

Duration of withdrawal*

One semester
One academic year
Permanently

Reason for withdrawal*

Name of institution you are transferring to if applicable

Assessment of Experience

Please help us assess the quality of your experience here. If you would take a few moments to respond to the following, the information you provide may help us improve the Indiana Tech experience for future students.

Is there anything else about your experience at Indiana Tech (positive or negative) that you think we should know about, which might improve the experience of future students?

Would you consider enrolling in Indiana Tech’s College of Professional Studies program to continue education online rather than withdrawing completely from the institution?

Is there anything we can do to help your transition to what you will be doing next (e.g., transfer to another school; obtain a job)?

Verification

Effective date of withdrawal/exit date*

Signature*

Date*