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Administrative Withdrawal

The Student Services Office, 210 Student Health Center, can help facilitate an administrative withdrawal from ALL classes for undergraduate and graduate students who experience one of the following situations: (1) A serious medical issue (2) mental health issue, or (3) death of a close family relative (parent, grandparent, sibling, child, spouse or engaged person).
For questions about Administrative Withdrawals, please contact LaTonya Matheney at 501-852-0786.

 

Administrative Withdrawal Request

Please read and complete the following information:

  • Supporting Documentation

    Please provide supporting documentation of the issue described above. Examples of secondary documentation include, but are not limited to: *Medical or Mental Health condition- brief, written statement by doctor or medical health professional. *Death of a close family relative- Obituary. This information can be sent to LaTonya Matheney by fax at 501-450-3248 or email at latonyam@uca.edu. **FAILURE TO PROVIDE SUPPORTING DOCUMENTATION WILL RESULT IN YOUR UNIVERSITY RECORDS BEING FLAGGED. IN ADDITION, STUDENT ACCOUNTS WILL NOT PRO-RATE YOUR TUITION AND FEES OR (IF ELIGIBLE) ISSUE A REFUND CHECK UNTIL SECONDARY DOCUMENTATION IS RECEIVED AND APPROVED**
    By checking "I agree", I authorize the Dean of Students office to release personal medical or mental health records to the following offices: Student Accounts, Registrar, Housing, Financial Aid and any other departments affected by my withdrawal from the university. (NOTE: the Dean of Student's office will only release specific documentation that is pertinent to the reason (or reasons) for student's withdrawal)