Course Withdrawal Form

    Please review the withdrawal and refund policies prior to submission and contact studentaccounts@sjcme.edu or finaid@sjcme.edu with questions regarding your specific financial situation.

    Complete this form and click submit.

    * Required Information

  • Your Contact Information

    • First Name:*

    Last Name:*

    Country:*

    Address:*

    City:*

    State/Province:*

    Zip/Postal Code:*

    Primary Phone Number:*
    Format: 555-111-9876

    Alternate Phone Number:
    Format: 555-111-9876

    Time Available:

    Email Address:*


  • Request

    • Is this a course or program withdrawal?*


    If course, which course(s) are you withdrawing from?

    Withdraw Course 1:

    Withdraw Course 2:

    Withdraw Course 3:

    Withdraw Course 4:

    Academic Advisor:*

    Withdraw reason:*

    Explanation:*




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