Notification of Withdrawal
from Programme /

QA Ref: STU9i; Maintained by: Student Records, Registry; Last updated: October 2017

Please read the guidance on fee liability on the reverse of this form

1 About you

Name / Student ID Number
Programme of Study / Year of Programme
Source of Funding
(e.g. Student Loans Company, Research Council or Self)
Address for Future Correspondence

2 Exact date left

My exact last date of attendance/active study was _ _ _ _ _/_ _ _ _ _/______/_ _ _
Day Date Month Year
(this is either the last day you attended, submitted a piece of work, or showed substantial engagement with online YSJU academic forums such as Moodle; for research students, the last point of academic contact)

Please note: The date you withdraw can have a significant effect on the amount of money you may need to pay for your Tuition Fees. This applies to students receiving a Student Loan Company (SLC) tuition fee loan as well as students paying their own fees. The withdrawal date will also affect your eligibility for maintenance funding from the SLC, bursaries and other benefits.

3 Reason for leaving

Please tick the explanation/s that best describe your circumstances

¨ Personal or family reasons / ¨ Medical reasons
¨ Financial difficulties / ¨ Transfer to another institution
¨ Offer of employment / ¨ Dissatisfaction with the programme or University
¨ Other

Please give further information on your reasons for withdrawing

Residential Services / If you are in University managed accommodation, please inform the Residential Services Team that you are withdrawing from the University. If you move out without the proper notification you may be liable for additional charges.
International students on Tier 4 Visas / If you withdraw from your course, the University is obliged to notify the Home Office of your withdrawal. This will result in your visa being cut short; you are strongly advised to contact the International Visa and Compliance Advisor at

4 Subject Director/School Research Lead Declaration

I ……………………...... confirm that the above student was invited to a consultation and I agree with their last date of attendance.*

Signed / Date

*This signature is to confirm that the student’s last date of attendance is correct and that the appropriate consultation has been offered to the student – it does not mean that the member of staff is in agreement for the student’s reasons for withdrawing (e.g. dissatisfaction with the University).

Please comment on any relevant dialogue with the student or if they declined the invitation for consultation (please note this section is compulsory to complete)

5 Student Declaration

¨  I confirm my intention to withdraw from the University and terminate my studies.

¨  I have obtained the advice and guidance I need to make this decision and fully understand the

implications of withdrawing.

¨  I have read the factsheet or webpage entitled ‘The implications of withdrawing from York St John University’ and understand the financial implications of withdrawing.

¨  I have handed my ID card back to the University (Student Advice Desk)

¨  International students on a Tier 4 Visa: I am aware of the visa consequences of my withdrawal and understand that the University will notify the Home Office of the discontinuation of my studies.

Signed / Date

Further information on withdrawing can be found on the Student web pages at:

https://www.yorksj.ac.uk/ssr/your-student-record-/withdrawal-/

6 For Research Degree students only

Please confirm that you have returned your YSJ keys to the Academic Development Directorate:

Fee liability 2017/18 and refund policy – for Students with a Student Loans Company (SLC) Tuition Fee Loan and Students paying their own fees

SEPTEMBER STARTERS
Withdrawal date / If tuition fees are paid through an SLC loan / If tuition fees are paid directly by the student / The SFE/SLC will pay the University the percentage of the fee indicated and you will later be liable to repay this money to the SFE/SLC
Once paid to the University this money is not refundable except for the period 11-24 September 2017 when the 25% fee loan paid will be returned to the SLC
11 September 2017 to 24 September 2017 / Money will be returned to SLC* / No fee
25 September 2017 to 31 December 2017 / 25% of year’s fee / 25% of year’s fee
1 January 2018 to 15 April 2018 / 50% of year’s fee / 50% of year’s fee
16 April 2018 to end of academic year / Full fees / Full fees
JANUARY STARTERS
Withdrawal date / If tuition fees are paid through an SLC loan / If tuition fees are paid directly by the student
Up to 21 January 2018 / Money will be returned to SLC* / No fee
22 January 2018 to 14 April 2018 / 25% of years fee / 25% of years fee
15 April 2018 to 16 September 2018 / 50% years fee / 50% years fee
After 17 September 2018 / Full fees / Full fees

*Even though the University will not charge you fees for this period, Student Finance England will count your week’s enrolment on the course as a year’s previous study. Your future funding will be affected.

Research students, Part time and Overseas students please contact the University Finance office to discuss your fee liability

When completed this document should be either scanned and emailed to:

or returned to:

Student Records, Registry, York St John University, Lord Mayor’s Walk, York, YO31 7EX

or handed in at the Student Advice Desk in the Holgate Student Centre