Cancellation or Withdrawal Request Questionnaire Student Name:(Required)Please provide your first and last name.Student ID Number:(Required)Please enter your student ID number including the first 3-5 zeros.Please provide the reason for your cancellation or withdrawal, so we can route your request to the appropriate staff. (Select all that apply)(Required) Academics Financial Employment Medical Mental Health Dissatisfaction with UMW Transfer Other If you selected "transfer" or "other" please explain the reason:(Required)Please state “N/A” if you did not select “transfer” or “other”.Do you plan to return to UMW?(Required) Yes No Unsure at this time Δ