Discontinuation Form

This site uses cookies to provide you with more responsive and personalized service and to collect certain information about your use of the site. You can change your cookie settings through your browser. If you continue without changing your settings, you agree to our use of cookies. See our Privacy Policy for more information.

Homepage

Advising
Catalogs
FAQ
Course Modality Definitions
Registration Help
FERPA
Forms
Staff

Request to Discontinue Enrollment

Students who submit a Discontinuation of Enrollment are voluntarily discontinuing their studies at Moody and will no longer be enrolling in courses in any venue. Students that have been discontinued will lose access to their Moody student account and will need to apply for readmission through the Office of Admissions if they want to return in the future. Please see the academic catalog for more information: https://www.moody.edu/catalog.

First Name

Last Name

Student ID Number OR Last 4 of SSN

Phone Number

Date of Birth

I am an F‐1 Visa (International) Student Yes No

Notify International Student Office

Purpose of request Financial Getting Married Medical Military Ministry Personal Transferring to Another School Other

I am requesting the discontinuation to be effective: immediately after the current semester other

When would you like the discontinuation to take place?

Personal Email Address:

Physical Address:

Signature: By typing your name below, you certify that you are the student and that you authorize this action for your own account. To proceed and submit this request, you must type your full name below.

Signature