CPS Professional Education Withdrawal Request Form

Students must petition the College for a withdrawal from their course(s) if there are extenuating circumstances (i.e. deployment, extreme medical emergencies, natural disasters, etc.) by completing the withdrawal form and providing supporting documentation.

Non-attendance does not constitute withdrawal from the University.

Students may be terminated for failure to meet course requirements as determined by their instructor.

All fields marked with an * are required.

Student Full Name *

Villanova ID Number *

Email Address *

Date of Birth *

Semester *

Are you a Veteran? *

Yes No

Are you receiving Veteran Benefits? *

Yes No

Program or Course Name

Please enter following information about your course or program. If you are withdrawing from 2 courses, please fill out the 2nd column.

Course Name *

Course Number *

Instructor *

Course Start Date *

Course Name

Course Number

Instructor

Course Start Date

Supporting Documentation (Required)

Please upload supporting documentation that explains the reason for your withdrawal. If the reason is Medical please attach reason and supporting Doctor’s Note.

Upload your Documentation here *

Signature

By typing your name in the text field below, you are acknowledging that all the above information is correct, and that this typed signature is as valid as a signed signature.

Today's Date *

Student Signature *

Upon completion, this form will be confidentially emailed to the CPS Academic Support Team. Please click "Submit" only once.