Official Exit Form

Official Exit Form

What is your reasoning for completing this form?*

Graduating Withdrawing

Select the option that applies:*

December Graduation May Graduation

Select the option that applies:*

Mid-Semester Withdrawal (Last Day of Class Participation) End of Fall Semester Withdrawal End of Spring Semester Withdrawl

Reason for Withdrawal*

Academic Difficulty Medical Personal Problems Financial Difficulty Transferring

Other:

Please enter last day of class participation.*

Transferring to:*

Plan to major in:*

General Information

Lees-McRae ID Number*

Name*

First Name

Last Name

Permanent Home Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Phone*

Personal Email *

(Not your Lees-McRae email)

Exchange Bookstore

Before leaving campus, be sure to return your textbook rentals to the Bookstore.

Textbook rentals must be returned to the Bookstore by the deadline at the end of the semester. If you fail to return your textbooks by the deadline, they will be yours to keep. The replacement cost charged to your student account will be 75% of the ‘New’ book price at the time of purchase. The non-return processing fee is 7.5% of the ‘New’ book price at the time of purchase. These fees are in addition to the rental fee. For more information, please visit the bookstore webpage.

Initials*

Financial Aid

In compliance with federal regulations, student borrowers of Federal Direct Loans who are graduating, leaving school (including transfers), or dropping below half-time enrollment are required to complete exit counseling. Because you have indicated that you are exiting Lees-McRae, Student Loan Exit Counseling is required. If you have borrowed from the Federal Student Loan Program while attending Lees-McRae College, you will receive a Student Loan Exit Counseling packet in the mail at your home address. Please watch for it in the mail, read over the information carefully, and respond quickly.

Initials*

Student Accounts

Please login to Montibus and review your student account balance. If a balance is due, please make payment.

Students are responsible for any and all amounts due on their student account. Failure to pay a balance in full means you will not be able to register for future classes, and you will not be eligible to receive grades or official transcripts until your account is paid in full. Any account over ninety (90) days past due may be turned over to a collection agency where your credit may be adversely affected. Once your account has been submitted to a collection agency, you must remit payment to them directly. Payment plans and/or other payment arrangements are not available to past due accounts. For more information, please visit the Student Accounts webpage.

Initials*

Student Affairs

Students are responsible for notifying the Office of Student Affairs of their move-out from student housing. Students should then turn in their key to a Residence Life professional staff member during the business day, or obtain an after-hours checkout paper from Residence Life. The room will be inspected for any damages after the student has moved out of their room. Students are responsible for any charges associated with damages or missing keys.

Initials*

Shelton Learning Commons

All Library materials must be returned by the end of the semester. The replacement cost for any outstanding materials will be charged to your student account.

Initials*

Once the form is received by the Office of the Registrar, your withdrawal from Lees-McRae College will be processed.

Signature*

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Use your mouse or finger to draw your signature above

Date/Time*