Petition for Withdrawal Form

Petition for Withdrawal Form

  1. Instructions

    We recommend meeting with the advising team for guidance, before completing this form.

    A student who petitions to withdraw from the PCHS intends to terminate their enrollment with the institution and will not attend/register for the term(s) indicated. If your petition to withdraw occurs after the official add/drop period, all fees are non-refundable and tuition charges will apply to courses as per the college’s course add/drop refund policy. Please see the catalog for details. Additionally, a student must complete exit loan counseling at PCHS Financial Aid.

  2. Student Information

    Please enter your information below.

  3. Required Information

    Please enter the required information below.

    Program (please select all that apply):


    Please select the reason for withdrawal (please select all that apply):

    Please select all that apply:

  4. Acknowledgements
    • Students who request to withdraw from PCHS will be dropped from all their courses.
    • Withdrawing may result in partial or full tuition and fees liability and/or a reduction or cancellation of your financial aid such as Excelsior, PELL, TAP, Stafford Loans, etc. It is recommended you consult with a Financial Aid officer prior to withdrawing to learn how your enrollment affects your awards.
    • Federal Aid may be adjusted based on the percentage of the semester completed, possibly resulting in a balance being owed to the College. Direct Loan borrowers must complete exit counseling with the Financial Aid Office or online at studentloans.gov.
    • If you have any outstanding balances, a hold will be placed on your account. Holds will prevent you from registering for future classes if you choose to petition to return at a future date.
    • Courses where less than 60% of the course hours have elapsed, will earn a grade of “W” or Withdrawal on their academic record with a prorated tuition charge.
    • Courses where 60% of the course hours have elapsed, will earn a grade of “WF” or Withdrawal Failure on their academic record with no refund of tuition. A grade of “WF” is calculated into the GPA.
    • The Registrar’s Office will process this request within 3 – 5 business days.
    • I have carefully considered this decision and wish to officially withdraw from the program.

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The Preferred Name Request form enables students, faculty or staff who wish to identify by a chosen name other than their legal first name the opportunity to request their first name be updated in our systems for the purpose of being seen and referred to by their preferred name. Last names can only be changed by legally changing your name through the court system. Please note that Name Change Request must be approved by the college administration and once approved, may take 7-10 business days to go into effect in our systems. Please refer to the College’s Preferred Name Policy for more information.

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