PCC > Admissions > Prospective Students > Withdraw Request

PUEBLO COMMUNITY COLLEGE
WITHDRAW FROM CLASS

Term   *       Year   *  

Initiated By:

Student

Instructor

INSTRUCTOR: DO NOT RETURN THIS FORM TO THE STUDENT. SUBMIT TO THE REGISTRAR'S OFFICE. THIS FORM INVALID THE LAST 20 PERCENT OF A SEMESTER OR ANY OTHER COURSE LENGTH.

Name   *       *    
                          First                                                                Last                                              MI

E-mail

Student ID #   *  

CRN #    Course ID             Credit Hours      Course Length  
                                                        Prefix        Course #     Sect. #

Last Date of Attendance

Withdraw Reason

Instructor

Date

NOTE: A "W" GRADE WILL BE POSTED TO THE STUDENT'S PERMANENT RECORD.