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
MM
/
DD
/
YYYY
Reason for Withdrawal (Please tick one or more of the boxes to describe the main reasons for withdrawing from the programme)
Required
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.
Please complete the captcha before submitting the form.
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