WITHDRAWAL FROM STUDIES FORM

We strongly recommend you contact the Student Services Department which can inform you of the financial
implications that your withdrawal may have if you are currently in receipt of a student loan, scholarship,
grants/bursaries or other allowances. It may also be possible that you owe fees following your withdrawal,
and this will be explained to you.

Student Number:

Surname:

Personal email
Address*:
Forwarding
Contact
Address*:

Course Title:

Year of Study:

Instrument/Voic
e (Music Only)

Last Date of
Attendance**:

Forename:

Note: The effective withdrawal date must be agreed with your Award Leader and Academic Services. This
is not necessarily the Last Date of Attendance

Date of
Withdrawal
Further
details:

Please provide as much detail as you can This information will be used for
statutory purposes

Reason for
Withdrawal:

Office Use: Personal:

Health reasons:
Financial issues:
Course unsuitable

Employment

Absent:

Student Declaration
I confirm that the information given by me on this form is to the best of my knowledge accurate
and complete. I further confirm that I have sought and obtained sufficient advice to inform my
decision to withdraw, and that I understand that this decision may have financial implications
which will be communicated to me as appropriate. I confirm that the Royal Welsh College of
Music and Drama may use the information contained on this form for statutory purposes, in
accordance with the terms of the Data Protection Act 1998.
Student
Signature:
Award Leader:
Student
Services:
Received
Academic
Services:
Notes:

Date:
PRINT

SIGN

Date:

PRINT

SIGN

Date:

PRINT

SIGN

Date:

*
It is vital that the College has contact information for students who are leaving; this will only be used
for the purposes of formal communication.
**
Your last date of attendance might not necessarily be the date on which this form is completed;
please discuss this with your Award Leader