Office of the Registrar : Forms

Student University Withdrawal Form

I hereby withdraw my current enrollment at Western Connecticut State University for the semester indicated above.

    I understand that this does not relieve me of any financial obligations to the University.

    I have read and understand the University's refund policy as stated on the website at

   Students living on campus are required to contact the Housing Office at 203.837.8531 to withdraw from housing.

    A withdrawal could affect your eligibility to receive or maintain financial aid. For more information, contact the Financial Aid Office at 203.837.8580.    

I understand that should I wish to return I must reapply through the Admissions office.

Withdrawals are effective the date this form is electronic submitted.

* Please review the information you have entered in the above form before clicking submit.