ANGLIA RUSKIN UNIVERSITY Notification of Leaving (R1a.1)

Before completing this form please contact your Programme Leader, Student Adviser or Director of Research. There may be alternatives to leaving your course which can be discussed with you. International Students – please ensure you contact an International Student Adviser as there may be implications regarding your student visa if you leave your course. Please also ensure you have read the “Thinking of Leaving” booklet available from i:Centres.

First Name: ……………………………………… Family name: ………………………………….…..

Student no: ………………………/….. Title of course: ……………………………………………..

Last date of attendance on the course : ……./ ….…/ ……. Academic year: ………../………….

Please ensure the last date of attendance is completed correctly. This date will be used to assess whether there are any fees implications resulting from you leaving.(If you completed your academic year please put last date of attendance as the end date of the academic year)

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Please tell us why you are leaving your course. We are keen to know whether we could have done more to help you stay.

Please indicate which of the following statements applies to you:

o  Nothing could be done to help my situation (1)

o  Anglia Ruskin may have been able to help but I did not know who to contact (2)

o  I did contact Anglia Ruskin who tried to assist me but my situation did not change (3)

o  I did contact Anglia Ruskin for assistance but did not receive any (4)

If you wish to make any further comments please do so below or provide an explanatory letter:

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Specific reason(s) for you leaving your course

We are required to let funding bodies know if you withdraw but we would also like to know why you have decided to leave.

Please indicate below the MAIN reason for you leaving:

o Transferred to another Institution (name of new institution): …………….…………………. (03)

o Health Reasons (04) o Personal Reasons (07)

o Financial Reasons (06) o Gone into employment (10)

o Other (11) please specify ……………………………………………………………………….

We are interested in collecting information on the underlying reasons or contributing factors behind students leaving. If you are willing to help us with this please, in confidence, indicate your reasons on the form R1a.2 – your reasons from leaving.

Please indicate whether you plan to return to Anglia Ruskin in the future: o Yes o No

Student’s Signature*: ...... ………...... Date: ......

Student Adviser/Programme Leader/Director of Research signature: ………………….………………..

Name (in block letters): …………………..…………………………………….. Date: ………………..

*Where student signature is not available Registration will accept form signed on the student’s behalf by a Student Adviser / Programme Leader / Director of Research

Office use only: Reason for leaving

o Academic Progress reasons (02) o Death (05) o Exclusion (09) o Did not re-register

o  Withdrawn by Faculty Research Degrees Subcommittee Date: ………………………………..

SWD screen
Delete PR on SCE
SLC CoC/Amount
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£………….. / Notify Accommodation
Notify Nurse Placement
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BLUE COPY – Registration YELLOW COPY – Academic Office (Assessments or FRDSC Sec) Chelms/Camb

PINK COPY - Timetabling WHITE COPY – Faculty 12/12