Student Withdrawal Form

The data you provide will be processed in accordance with the QMU Data Protection Policy available at here.

Please note:

Students are encouraged to discuss their options with their Personal Academic Tutor, Programme Leader or other University support services before submitting their form. More information can be found on the Thinking of Leaving website and in the Student Guide to Services at QMU.
International students studying on a Tier 4 student visa should seek advice from the International Student Support Coordinator (email international@qmu.ac.uk) before completing this form as withdrawing from their studies will affect their Tier 4 student visa status.
Students who live in University accommodation should contact Accommodation Services to discuss their situation as they will remain liable for rent for the duration of their tenancy agreement.
If your programme included a placement and you were issued a uniform, you must return your badge and uniform (consisting of four tunics and four trousers) to the University promptly. The badge will be destroyed for confidentiality, and the uniform will be added to our second-hand stock for future students in need. Please return the uniform to the Registry Information Point. If you have any questions, contact Placement Administration at PPSO@qmu.ac.uk.
Once you have submitted the form, you will be sent an email with a link asking you to confirm your withdrawal. Please note that you will not be withdrawn until you have done this.

(All fields marked with an asterisk (*) are required.)

First name*

Last name*

QMU Student / Matriculation number*

Date of last attendance*

Main reason for withdrawal*

Please provide details of your reasons for withdrawing*

I confirm that I wish to withdraw from my programme.

The University will consider the completion of this form, and the ticking of the confirmation box as being equivalent to a signature, a further confirmation will be sent to your QMU email address requesting authorisation on submission of this form.