Please ensure the form is duly signed in Section C before submission. SECTION A: Student's Particulars. Full Name. Admission No.

Course. Tutorial Group.

Contact .... Students who wish to withdraw from a module must submit a module withdrawal application at least four weeks (or two weeks in the Summer Term). Surrender/Withdrawal process will be based on the date of application stated in this application form. 3.

Any payment received after the application date for .... The date of receipt of this withdrawal form by the University College is the official date of withdrawal.

ii. Any application for withdrawal by students ....

APPLICATION FOR OFFICIAL WITHDRAWAL (Undergraduate Student). This form should be completed and returned to the Undergraduate Studies Section within 3 working ....