Course Withdrawal Form Header Image

Welcome

The deadline for submitting a withdrawal request may be found at https://www.escc.edu/students/academic-calendar/. Please note that withdrawal requests are automatically timestamped at the time of their submission and only requests submitted before 11:59 pm on the final day to withdraw will be processed.

Student Information

It is the student's responsibility to understand how withdrawing from a course/all courses will impact their financial aid and if they will owe any funds back to the College. By submitting this form the student understands this and accepts responsibility.  Please turn in any rental items or unused access codes from the ESCC Bookstore or a hold may be placed on your student account.

Name*
Date*
Address*
Please check ALL of the following statements that apply to you:*
What is the most significant reason that you are withdrawing from a course?*
Do you wish to withdraw from ALL courses at ESCC this semester?*
Are you currently a dual enrollment student?*
Are you a student in the SSS program (Student Support Services)?*
Use your mouse or finger to draw your signature above

Course(s) To Be Withdrawn

e.g. ENG-101
e.g. 5701
e.g. English Composition I
e.g. Dauphin

Advisor/Registrar Approval

Approve or deny:*
Use your mouse or finger to draw your signature above
Cancel
Confirm