*Name (Last, First Middle Initial): ,

*Student ID Number (preferred) OR e-ID:

*Date of Birth: Month January February March April May June July August September October November December Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2015 2014 2013 2012 2022 2020 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930

*Phone Number: () - *Preferred Email:

*Term Withdrawing: Fall Spring Year 2020 2021 2022 2023 2024 2025

*Reason for Cancelling Admission: (please check one)
-- Please choose a reason -- COVID-19 JMU is not a good fit for me I wish to be closer to home Financial Obligation Health/Medical Plan to attend another college/university Job opportunity Not able to pursue desired major/program Other
 

Comments/Reason for Cancelling Admission:


*You must confirm your understanding of your cancellation from JMU by checking the boxes below:

I understand that by completing this cancellation notice, my financial aid application, and all financial aid offers, including scholarships, grants, etc., may be cancelled. If I decide to apply to JMU in the future, I understand that I need to complete a new financial aid application, and re-start the process for the semester I am admitted.

I understand that I qualify for a refund of my deposit from the Office of Admissions if this form is completed by my deposit refund date. I understand that if I decide to come back to JMU in the future, I must re-apply through the Office of Admissions.

I understand that the Orientation fee will not be refunded. The Orientation fee covers all orientation materials, preparation, and programs. All students are charged the Orientation fee whether or not they choose to attend Orientation activities.

I understand that if I have signed a housing contract with the Office of Residence Life, I must notify them by calling 540-568-4663, in addition to cancelling my admission to JMU. If I decide to return to JMU in the future, I will need to contact the Office of Residence Life to re-activate my housing contract, and arrange housing.

I have read, and checked, the above statements and understand that once this form is signed, dated, and submitted to the Office of the Registrar, that my admission has been cancelled. I understand that I will be notified via the preferred email listed above to confirm my cancellation.

*Student Signature: *Date: