Withdraw Request Form

Program: ex. AA, BUS, CNT, CJ, HSV, HCA, MDT
I want to withdraw from the following course(s):
Select the Course:
Select the Course:
Select the Course:
Name:
Phone #: ex. 5159559874
Address:
City:
State:
Zip Code:
Your Email:
*Student ID #:
*If you don't know your ID number, go to WebAdvisor to find it.
 
Reason for Withdrawal: Please choose each reason that applies to you:
Please check all that apply

I found the course too difficult
I fell behind in my coursework
I didn't find the course materials interesting
The pace/workload was too great
I needed more contact with tutors
I didn't have the study skills/background knowledge required
I didn't have the required motivation
I didn't have the cofidence to carry on
I decided to take another course elsewhere
I underestimated the study time required
   
Lack of time for study due to:
Please check all that apply
General/work pressure
Increased pressures at home
Increased pressures at work
   
Barriers preventing successful study:
Please check all that apply
Personal Illness
No quiet place to study
Problems with access to a computer
Lack of support from family/friends
Lack of support from employers/colleagues
I have a new job/promotion
Any other reason - Please explain
   
Please Explain
   
Reasons for Study - Which of the following best describes your original reason for choosing to study this course?
Please check all that apply
Job related/promotion
Personal development
Job related/promotion and personal development
   
Do you plan to continue with your studies?
Choose one:
Yes, I plan to continue. Please reschudule me for the next start date
   
No, I need to take a break from classes. I will contact my Enrollment Counselor for available re-entry dates.
   
No, I have given up my studies at Iowa for good
   
Comments
   
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