CS Late Withdraw Petition Form

Student Information
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(Month/Year)
Course History Information
Provide the 3-digit catalog number, full title, and number of credits , e.g. CMPSCI 105, Introduction to Programming, 3.00, for the course that you are requesting to withdraw.
e.g., CMPSCI 105
e.g., Introduction to Programming
e.g., Fall 2016
This is the 5-digit class number for the specific class or section you are requesting to withdraw.
If necessary, include the 5-digit class number for the specific lab you are requesting to withdraw.
Justification
I understand that this appeal will be reviewed by the Advising Committee and I will be notified of the decision by email. I understand that I must continue to attend the course(s) that I am requesting a late withdrawal(s) until I am notified that the late withdrawal(s) was approved. I understand that if verification is needed, that it is my responsibility to provide it to the committee.