Notice of Intention to Withdraw
This form should be completed and checked by CSE at least 7 days before leaving.
Once submitted, you will be given "Student Withdrawal Form".
Email address *
Student Full Name *
Your answer
Programme *
Student ID *
Your answer
Student's Mobile Number (In 01X-XXXXXXX format) *
Your answer
Home Address (in CAPITAL LETTERS) *
Your answer
Last day to attend lecture *
Reason for Withdrawal (Please tick one or more of the boxes to describe the main reasons for withdrawing from the programme) *
Did you get any help/advice before you decide to withdraw? If so, with whom did you work and what were the results? *
Your answer
Describe your experience in UNIMY (academic, extracurricular, accommodation, social experiences, etc) *
Your answer
What do you think UNIMY should change that could make you re-think to leave? *
Your answer
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms