Application for Withdrawal

Things to consider prior to taking a leave or withdrawing from the college:

We care about you and your success! Any student who is considering withdrawal is strongly
encouraged to make an appointment with the Enrollment Specialist, Lisa Bishop.
lbishop@geneseo.edu, 585 245-5463. Students can make an appointment through Navigate
with the following link:
https://geneseo.campus.eab.com/pal/-w5rXxrAVJ

Official Withdrawal

Official withdrawal removes a student from any academic program and cancels the student’s matriculated status at Geneseo. You should only complete this withdrawal form if you do not plan to return to the college.

Academic dismissal or disciplinary suspension or dismissal will supersede any withdrawal.
To begin the official withdrawal process, students must submit this electronic form. Your
withdrawal is effective on the date that the completed, signed form is submitted. This
effective date is used for assessing financial liability, and for determining eligibility for
federal, state and institutional financial aid (if applicable). Students can review
Geneseo’s financial liability deadlines at the Student Accounts website.
Students who request an official withdrawal before the "W" deadline (https://www.geneseo.edu/registrar/academic-calendar) are assigned W grades.
If you receive financial aid and withdraw before completing the entire semester, please be aware that certain laws may affect your aid, resulting in a financial liability to SUNY Geneseo. Federal law mandates how a school must compute the amount of federal financial aid a student earns if he/she withdraws (officially or unofficially), takes a leave of absence, drops out of school, or is dismissed prior to completing more than 60% of the semester. Specifically, the amount of federal financial aid that the student earns is based on the percentage of the semester completed. All unearned federal financial aid must be returned, while the semester's expenses may not change. Please review Geneseo’s Return of Title IV funds policy for complete details. You are encouraged to consult with the Office of Student Accounts (Erwin Hall 103, 585-245-5621) or the Office of Financial Aid (Erwin Hall 104, 585-245-5731) prior to submitting this form.

For questions, please email loa-withdrawal@geneseo.edu

Additional Resources:

Financial Aid (Erwin Hall 104, 585-245-5731)
Student Accounts (Erwin Hall 103, 585-245-5621)
LOA Policies and Procedures (PDF)

First Name

Middle Name

Last Name

Email Address

Geneseo ID

Date of Birth

Mailing Address

Country

Street

City

Region

Postal Code

Are you interested in an appointment to discuss options and answer questions?

Yes

No

You can schedule an appointment here:

https://geneseo.campus.eab.com/pal/-w5rXxrAVJ

Select one

What date did you last participate in class?

Enter semester

Are you currently on a leave of absence?

Yes

No

If you are a financial aid recipient (loans, grants and/or scholarships), have you contacted the Financial Aid Office about the effects of a withdrawal on your aid?

I have already contacted the Financial Aid Office

I plan to contact the Financial Aid Office

I am not a financial aid recipient

If leaving before completing the current semester, have you reviewed the College’s financial liability policies and/or discussed your withdrawal request with the Student Accounts Office

I have already contacted the Student Accounts Office and understand the financial liability policies

I plan to contact the Student Accounts Office

Not applicable

Do you currently live on campus?

Yes

No

Please reach out to the Residence Life Office to let them know you will not be returning to campus.
(585)245-5726
reslife@geneseo.edu

Are you transferring to another college?

Yes

No

Name of college

Reason(s) for Withdrawal (hold down ctrl to select more than one)

If you are transferring to pursue a major not offered at Geneseo, please list the major.

Please specify