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 or planning a leave or withdrawal may want to consider seeking advice from the Dean of Academic Planning & Advising, Dean of Students, the enrollment specialist, an advisor, or other college employee before applying for the leave or withdrawal.

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.
Your withdrawal is effective on the date that the completed, signed form is received at the Office of Admissions. This effective date is used for calculating billing and refunds, and for assessing financial liability. Students can review the 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.

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

Additional Resources:

Admissions (Doty Hall 200, 585-245-5571)
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