Student Withdrawal Form

Student ID*

Email after withdrawal*

Phone after withdrawal*

Are you an athlete?*

Team*

Coach*

I am withdrawing:*

Make sure to request your transcripts if you plan to transfer. They will not be automatically sent.

Do you live on campus?*

This includes Ridgecrest Residence Halls.

Building*

If exiting during the semester, you have 24 hours to vacate your room from the time you submit this form.

Building Room Number*

What kind of Meal Plan did you have?*

Degree/Major*

Advisor*

Class Level*

Please note the positive and negative aspects of Montreat College as you see them.*

What would have improved your experience at Montreat College?*

What year and term do you plan to return?*

Desired major*

Other reason for withdrawal*

What do you plan to do after leaving Montreat College?*

Name of future Institution:*

If other:*

How likely are you to recommend Montreat College to others on a scale of 1-10? (1 being least likely and 10 being most)*

Affirmations

I understand the following as they relate to my withdrawal from Montreat College:

Pending academic suspension or disciplinary action may affect any applicable refund. Please see the current Academic Catalog and Student code of conduct for specific details, as applicable to your situation.
Fines/Fees are assessed upon failure to return room and/or mailbox keys, library materials, and any College-owned equipment/materials.
Any potential credit balance on a student account after withdrawal calculations are completed will be issued upon written request. Contact the Student Financial Services Office for information on requesting a credit balance.
A balance owed to the College upon and after withdrawal places a financial hold on your account that will block release of transcripts until paid in full.
I am responsible to arrange to have my USPS mail forwarded to another address.
My Montreat College email address will be deleted no more than 15 months after I withdraw.

Student Electronic Signature: Typed*

I agree and acknowledge that this document can be executed electronically and it is binding in every way as if signed by my hand.