Domestic Withdrawal Application
Are you registered in any Open Learning Courses?
| Type | |
| Size | 203 KB |
Referenced from: Withdrawal & Refund Information
Document text
Domestic Withdrawal Application
Student Name
Student #
Street
City
PO Box
Province
Country
Postal Code
Phone
Program
Campus
Part A: Primary Information
Part B: Address
Part C: Reason for Withdrawal (check appropriate box)
-
Financial Pressure
-
Left to Attend Another School
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Personal
-
Program Not Suitable
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Other (Please Specify)
-
Health
-
Program Related Difficulties
-
Left to Take Job
Are you registered in any Open Learning Courses?
-
Yes
-
No
-
No
-
Yes
Do you wish to continue in these courses after withdrawal?
Advisor’s Comments
Date
-
No
-
Yes
OSAP Student
Part D: Returned Items
Laptop and any other
resources returned
-
No
-
Yes
Signature - Advisor
Signature - Coordinator/Director
Date
Coordinator’s Comments
Declaration: I certify that I do not hold any article(s) that may be considered the property of Northern College.
Signature - Student
Date
Connected with a Financial Aid Officer
Verified L earning Resource Center
Signature - Student
Signature - Library Technician
- N/A
Only required after Day 10 of the current semester.
Only required after Day 10 of the current semester.
Source: https://www.northerncollege.ca/uploads/2025/09/Withdrawal-Form.pdf