Withdrawal Notification Withdraw PolicyA student who wishes to withdraw from the university must complete this form, which is then submitted to the Registrar’s Office and other student services departments. Tuition refund is based on the date on which the completed form is sent to the Registrar’s Office. If a student withdraws PRIOR to “the last day to drop a course” for the term, a grade of “W” will be recorded on the transcript for all courses in which the student is enrolled. If a student withdraws AFTER “the last day to drop a course” for the term, a grade will be assigned for all courses in which the student is enrolled based on all of the course requirements (including any remaining assignments). Any student who withdraws from the university without completing this online form, will have a grade of “F” recorded on the transcript for all courses in which the student is enrolled. Appeals will be considered on a case-by-case basis and must be presented in writing to the Registrar.Departments to ContactContact the Dean of Students at firstname.lastname@example.org or Learning Services at email@example.com to schedule an exit interview. This must be completed in order for this form to be considered complete.Contact Student Life at firstname.lastname@example.org to discuss your dorm exit date and the return of your dorm key (if you live on campus).Contact the Students Accounts office at email@example.com to discuss your tuition account.Contact the Financial Aid office at firstname.lastname@example.org to discuss OSAP or any other financial matters.Contact Campus Services at email@example.com to discuss meal plans or campus cash balances.Contact the Registrar’s Office at firstname.lastname@example.org if you have any questions about your courses or program. Student InformationName(Required) First Last Student ID Number(Required)Permanent Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Student Residency(Required) I was living on campus I was living off campus Dorm NumberIf you lived on campus in a dorm, provide the dorm number. DateProvide the date that you will be moving out of the dorm. MM slash DD slash YYYY Cell Phone Number(Required)Redeemer Email(Required) Personal Email(Required) Withdraw InformationDate of Withdraw(Required) End of the FALL term (not returning for the winter term) End of the WINTER term (not returning for the next academic year; IT IS NOT REQUIRED TO CONTACT THE OTHER STUDENT SERVICES DEPARTMENTS) On this date: Withdraw Date MM slash DD slash YYYY Reason for Withdraw(Required) Financial Health Issues Personal Reasons Going to work Going on a mission trip Transferring to another institution I plan to return to Redeemer Other Transferring to another institution.Please provide the name and program. Planning to return to Redeemer.Please provide the term that you plan to return to Redeemer. Tuition and Fees Refund PolicyRefunds of tuition for the term currently enrolled in will be made only from the withdrawal date on this form.Refunds of tuition and Redeemer Student Fees and Student Senate Fees will be calculated according to the table the Academic Calendar. Transit fees are not refundable. The student should be aware that any aid, such as bursaries, grants, loans, scholarships, etc., received from Redeemer University and/or private sources for the term (or academic year if so stated in the notice of award) will be forfeited in full. Reclamation of this aid will be charged against any refund due. If there is no refund due, the student is responsible for any outstanding balance on their financial account caused by the forfeiture of this aid. If a student does not complete the academic year and has received government funding, this funding will be re-assessed. Any refund will be used first to repay any government funding overpayment caused by this re-assessment, after which the student will receive the residual refund, if any. https://www.redeemer.ca/academics/academic-calendar/Food and Housing Refund PolicyRefunds of housing fees will be allowed only in case of withdrawal from the University. A student withdrawing from housing (but not from the University) will be charged 100% of the term housing fees. A student withdrawing from housing (and from the University) will pay a percentage of the term housing fee based on the table on page 28 of the Academic Calendar.Please note that there may be extenuating reasons that could result in an exception to this policy. Refunds of food plan fees will be made on a pro-rated basis. Refunds of flex dollars will be based on usage.Student ConsentInformation is Correct(Required) I agree to the above information is correct.Withdraw Policy(Required) I have read with withdraw policy.Tuition Refund Policy(Required) I have read the refund policy as outlined in the Academic Calendar.Food/Housing Refund Policy(Required) I have read the food/housing refund policy as outlined in the Academic Calendar.Contact Departments(Required) I am aware that it is my responsibility to contact the various departments regarding my withdraw.