Request to Withdraw 2

Please note:   The copy & paste feature is not available in this form
I am considering a temporary OR permanent withdrawal from Middlesex University and I understand that I will be contacted to discuss my decision.

Please note: This is only a request and the completion of this form does not mean you have withdrawn. To finalise your withdrawal you must speak to a Progression and Support Advisor.

We will attempt to contact you three times. If we are unable to contact you your request will be closed and you will not be withdrawn.

If you do not hear from us within 3 working days following submission of this form, please call 02084114423 (Monday – Friday, 9am – 5pm)
Student Number *
First Name, Surname *
Programme *
I am considering a : *
Please tell us why you are considering a temporary OR permanent withdrawal from the university * (select a reason from the drop down menu)
Please provide a telephone number so we can contact you during our office hours to discuss your request *

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