ࡱ> UmTm rbjbjZcZc 6Q8 b8 bJ'XXT</P:9%9%9%;/=/=/=/=/=/=/$1T4Ta/9%"9%9%9%a/v/'''9% ;/'9%;/'':,,[-0mO%, '//0/ -R4e%4[-[-4o-9%9%'9%9%9%9%9%a/a/}&*9%9%9%/9%9%9%9%49%9%9%9%9%9%9%9%9%XB : Withdrawal Form This form must be completed in full if you wish to withdraw from the university and do not intend to interrupt your studies. Before withdrawing, please make sure you have sought all the advice you require to make an informed decision. There may be academic or financial implications to withdrawing. Please ensure you have read and completed the checklist below. Student Details Forename Surname  Course Student number  Telephone number Email address  Reason for Withdrawing from studies (please tick one main reason) W1 Financial Difficulties W2 Personal Problems W3 Health Reasons  W4 Transfer to another Uni W5 Employment W6 Placement issues W7 Dissatisfied with course W8 Wrong Career Choice W9 Other (specify below) Has an interruption of studies option been explored with student? Yes/ NO /N.A Circumstances for withdrawal: (Provide a brief outline of circumstances surrounding the reasons for withdrawal) __________________________________________________________________________________________________________________________________________________________________________________________________________________ Completed withdrawal of studies forms sent to the Student Engagement Team will be reviewed and you will receive correspondence from a member of the team. A completed formdoes not mean that the withdrawal request will be automatically processed at this stage. The date the form is submitted will be used as the date of the withdrawal of studies, the university cannot backdate your request. Declaration (student section) By signing this form you are confirming that you consent for the Student Engagement Team to send this document and details of the circumstances of your withdrawal to your course administrator for review and to process. You are also confirming you are aware of the consequences of your decision on both academic and financial grounds. If you are submitting the form electronically, please also put a cross in the box to confirm: Signature of student ______________________________ Date form submitted: _______________________ Send completed form, email form to  HYPERLINK "mailto:student.engagement@beds.ac.uk" student.engagement@beds.ac.uk or address to Student Engagement, ý, Park Square, Luton, LU1 3JU, if submitting by post. This form will be sent by the Student Engagement Team to your course administrator to review and process. Checklist (Advice confirmed by student engagement advisor during appointment and/or through email correspondence Have you signed and dated the form (or put a cross in the box if submitting electronically)? Have you discussed your Withdrawal with your Personal Academic Tutor or academic team? Have you spoken to the Student Finance Officer to make sure you are aware of the financial implications/ fee liability and notified Student Finance England (SFE) or other financial sponsor as appropriate? If you are living in ý halls, have you informed the accommodation office? You must return your ID badge to a member of staff either course admin, reception, SID desk or member of security. ID cards will be deactivated and you will no longer have access to university buildings after you have withdrawn from your studies. International students studying in the UK, you must contact the International Office regarding any withdrawal of study requests. The UK Visa and Immigration (UKVI) will be notified of your withdrawal. Contact  HYPERLINK "mailto:IntStudentExperience@beds.ac.uk" IntStudentExperience@beds.ac.uk Overseas students studying at partner centre/college, ensure you have consulted with local partner staff for academic and financial implications. NHS LSF students, you are advised to inform your Student Finance Officer at  HYPERLINK "mailto:sfohealth@beds.ac.uk" sfohealth@beds.ac.uk NHS Students, you must return your NHS badge and uniform. Engagement Advisor Review Section: (to be completed by Student Engagement Advisor Only) Any additional comments (if applicable) Student Engagement Advisor (full name): ____________________________________________________ Date form processed to course administrator (internal use): ___________________ Exit Interview Section - Personal Academic Tutor (PAT) Section or Overseas Partner Centre/College Staff: Last date of attendance: Mode (FT / PT) Level of ý  *Course Administrators - if the student has completed all work for this academic year please use the Academic Year end date Please provide any additional comments (if applicable) ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Exit Interview conducted by (staff member full name): _____________________________ Staff member signature: ________________________ Date: ____________ Reason for leaving code (NHS students only) _____________________ Is there anything the ý could have done to enable you to stay on the programme? 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