LATE COURSE WITHDRAWAL FORM
McGill University- Students in the Faculty of Arts, Science, Arts & Science
https://www.mcgill.ca/study/university_regulations_and_resources/undergraduate/gi_regulations_concerning_course_withdrawal
This form must be completed and submitted to Service Point for review.
Section 1: Student Information
Full Name:___________________________________________
Date:__________________________
McGill ID Number:____________________
Faculty:_____________________________
U0
U1
U2
U3
Exchange/Special/Visiting
Section 2: Guidelines and Instructions
ALL sections of this form must be completed.
The following two items must be included with your request:
1.
2.
Relevant supporting documentation (e.g. medical note, death certificate)
A clear and concise personal statement (TYPED, double spaced) which must explain each of the following:
•
Why you did not withdraw from the course(s) prior to the relevant deadline
•
The circumstances which led you to request a late course withdrawal (address each circumstance separately)
•
The steps you are taking to address your situation and to prevent it from reoccurring (i.e. your action plan)
Requests will be considered based on their own merit. Requests will be refused for any of the following reasons:
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Anxiety about getting a poor grade in the course
Absence for social or leisure events
Absence due to pre-arranged holidays/vacations, including overseas travel
The course not being part of your academic program
Where you have already written your final exam
Where you have already received a course grade other than J or K
Where you have previously made similar requests for similar reasons
All information pertaining to your request is confidential. Circumstances may arise in which it is appropriate for a faculty or staff
member to disclose personal information about a student to the Dean of Students. These situations arise when a member of faculty
of staff develops a concern about a student’s personal health or safety, or the safety of others. In some cases Service Point may
need to contact your course instructor for information regarding your performance or attendance in the course you’re requesting a
withdrawal from.
Students receiving financial aid should contact the Student and Student Aid Office Financial Aid regarding whether their Aid status
will be impacted if this request is approved. Tel: (514) 398-6013
International students should contact McGill International Student Services regarding whether their immigration status will be
impacted if this request is approved. Tel: (514) 398-4349
Section 3: Student Declaration and Authorization
You must declare and authorize the following:
☐ I am aware of the McGill’s regulations regarding course withdrawal, and have read the information provided with this form.
☐ I declare that all of the relevant supporting documentation is attached, is accurate, and is verifiable.
☐ I am aware that a $50 administrative fee per approval/course will be applied to my student fee account.
Student Signature: ______________________________________
Updated November 21st, 2016
Date:______________________
http://www.mcgill.ca/students/records/forms
Section 4: Student Self-Assessment and Self-Identification
Use the following as a guide to help formulate your personal statement. You are encouraged to provide as much
information as possible in support of your request. If you agree with any of the following statements, or find yourself in a
difficult situation and would like additional help with any of the items listed below, please consult your academic advisor or
Service Point.
Personal Concerns
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•
•
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I have been experiencing difficulty adjusting to living away from home.
I feel very disconnected from other students in my program/residence.
I have been experiencing stress regarding my family/relationship.
I have been experiencing personal difficulties that have impeded my ability to complete/attend class.
I have recently undergone or am currently experiencing considerable physical/emotional health concerns.
I am experiencing urgent financial, job-related and/or housing concerns.
Health Concerns
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I have a diagnosed learning disability or suspect that I do and I am having trouble managing the course material.
I am registered with the Office for Students with Disabilities (OSD) – (514-398-6009).
I live with anxiety or depression that affects my daily life and/or academic performance.
Academic Concerns – (Please contact your Faculty Advisors to discuss these)
•
•
•
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I question whether my current program of studies is right for me.
I need to develop better time management, study and organizational skills.
I tend to procrastinate and did not study enough.
I tend to panic when writing exams or making presentations.
Section 5: Course Information
I wish to request late withdrawal from the following courses:
Term
(eg. Fall 2016)
CRN
(eg. 27416)
Subject
(eg. ECON D1)
Course
Number
(eg. 227)
CRN of Linked Activity
(eg. Lab, Tutorial, etc.)
CRN of 2nd term
(if full year course,
eg. ECON 227D2)
Course 1
Course 2
Course 3
Course 4
Course 5
For Staff Use only:
SP decision SP name & date
(W/WF/WL)
Updated November 21st, 2016
Manager
(DD/WC-R)
FEE (Y/N)
# pages
Heat ticket
http://www.mcgill.ca/students/records/forms