Online and Distance Education
Course Total Withdrawal Form

Important Information

By completing this form you are requesting a “total” withdrawal from the university for a specific term. We strongly encourage you to contact your advisor regarding this request so they may advise you based upon your particular needs and plan of study.

If you have financial aid, it is imperative that you contact the Office of Scholarships and Financial Aid to find out how this could affect your aid; they can be reached at 1-800-227-4017 or 765-285-5600.

Please be advised that this will be a total withdrawal and you will receive a “W” on your transcript. In addition, registering for a another course during the same term after totally withdrawing could result in financial obligations and a need to have your enrollment status changed to allow registration once again.

All refund amounts will be determined by the date the total withdrawal request was submitted and the length of the course/s. The Bursar Office’s Refund Schedule may be viewed here. You may contact the Bursar Office with questions at 765-285-1643.

Please contact the Online and Distance Education office with questions you may have regarding this process at 765-285-1581, 800-872-0369, or online@bsu.edu.

Confirmation*

Contact Information

Use this form if you are withdrawing from your last or only online and distance education course.
Drop/Withdrawal Process: View the refund schedule
After you click 'Submit,'' please print the next page for your records.

Name*
Please submit your Ball State email address only. Confirmation emails will only be sent to your Ball State email account. We can no longer send drop/withdrawal confirmation emails to personal email accounts.

Course Information

Include course prefix and number
Include course prefix and number
Why are you withdrawing from your courses? (Check all that apply)
Are you planning on enrolling in the next semester?*

Confirm Your Request for Withdrawl

Name: {$29642613 Name}

Address  {$29642622 Address}

Phone:  {$29642656 Phone}

Email:  {$29642657 Email}

Term:  {$29643410 Term}

Course One:  {$29643437 Course One}

Course one delivery method:  {$29643531 Course One Delivery Method}

Course Two:  {$29643547 Course Two}

Course two delivery method {$29643544 Course Two Delivery Method}

Miller's Merry Manor or TLC Employee:  {$29643577 Are you a Miller's Merry Manor or TLC employee?}

Why are you withdrawing:  {$29643581 Why are you withdrawing from your courses?...}

Are you planning on enrolling next year:  {$29643612 Are you planning on enrolling in the next...}