{"id":3408,"date":"2024-10-21T14:31:21","date_gmt":"2024-10-21T21:31:21","guid":{"rendered":"https:\/\/www.ewu.edu\/highschool\/?page_id=3408"},"modified":"2026-08-27T14:40:55","modified_gmt":"2026-08-27T21:40:55","slug":"drop-withdrawal-request-form","status":"publish","type":"page","link":"https:\/\/www.ewu.edu\/highschool\/drop-withdrawal-request-form\/","title":{"rendered":"Exceptional Circumstances Withdrawal Request Form"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"author":1363,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-modules.php","meta":{"_acf_changed":false,"footnotes":"","_members_access_role":[],"_members_access_error":""},"class_list":["post-3408","page","type-page","status-publish","hentry"],"acf":{"blocks":[{"acf_fc_layout":"text","module_background_color":"white","copy":"<h2>Exceptional Circumstances Withdrawal Request Form<\/h2>\n<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_29' ><div id='gf_29' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <p class='gform_description'>If a student encounters an unforeseen circumstance that prevents them from completing their enrolled course(s), this form is used to request a withdrawal after the official withdrawal \u201cW\u201d deadline.<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_29' id='gform_29'  action='\/highschool\/wp-json\/wp\/v2\/pages\/3408#gf_29' data-formid='29' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_29' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_29_164\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_164'>Name of Person Submitting this Form<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_164' id='input_29_164' type='text' value='' class='medium'  aria-describedby=\"gfield_description_29_164\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_29_164'>First and last name<\/div><\/div><div id=\"field_29_166\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_166'>Role<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_166' id='input_29_166' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='High School Instructor' >High School Instructor<\/option><option value='School Counselor' >School Counselor<\/option><option value='Registrar or Administrator' >Registrar or Administrator<\/option><\/select><\/div><\/div><div id=\"field_29_167\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_167'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_167' id='input_29_167' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_29_168\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_168'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_168' id='input_29_168' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_29_171\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><b>Student Information<\/b><\/div><div id=\"field_29_173\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_173'>Student Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_173' id='input_29_173' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_29_175\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_175'>EWU ID Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_175' id='input_29_175' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_29_177\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_177'>Student&#039;s Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_177' id='input_29_177' type='text' value='' class='medium'    placeholder='MM\/DD\/YYYY' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_29_178\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_178'>Student&#039;s Last Date of Attendance<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_178' id='input_29_178' type='text' value='' class='medium'    placeholder='MM\/DD\/YYYY' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_29_179\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><b>Course Information<\/b><\/div><div id=\"field_29_180\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_180'>Term<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_180' id='input_29_180' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Fall Semester' >Fall Semester<\/option><option value='Fall Trimester' >Fall Trimester<\/option><option value='Yearlong' >Yearlong<\/option><option value='Winter Trimester' >Winter Trimester<\/option><option value='Spring Semester' >Spring Semester<\/option><option value='Spring Trimester' >Spring Trimester<\/option><\/select><\/div><\/div><div id=\"field_29_183\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_183'>Academic Year<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_183' id='input_29_183' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='2026-2027' >2026-2027<\/option><option value='2027-2028' >2027-2028<\/option><option value='2028-2029' >2028-2029<\/option><option value='2029-2030' >2029-2030<\/option><\/select><\/div><\/div><div id=\"field_29_184\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_184'>Course Title and Course Code<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_184' id='input_29_184' type='text' value='' class='medium'  aria-describedby=\"gfield_description_29_184\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_29_184'>e.g. ENGL 101-H01<\/div><\/div><div id=\"field_29_189\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><b>Instructor Information<\/b><\/div><div id=\"field_29_185\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_185'>Instructor Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_185' id='input_29_185' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_29_186\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_186'>Instructor Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_186' id='input_29_186' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_29_187\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_187'>Instructor Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_187' id='input_29_187' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_29_191\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Reason for Withdrawal<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_29_191'>\n\t\t\t<div class='gchoice gchoice_29_191_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_191' type='radio' value='Medical (Self or Family)'  id='choice_29_191_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_191_0' id='label_29_191_0' class='gform-field-label gform-field-label--type-inline'>Medical (Self or Family)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_191_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_191' type='radio' value='Death in the Family'  id='choice_29_191_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_191_1' id='label_29_191_1' class='gform-field-label gform-field-label--type-inline'>Death in the Family<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_191_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_191' type='radio' value='Transferred Schools'  id='choice_29_191_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_191_2' id='label_29_191_2' class='gform-field-label gform-field-label--type-inline'>Transferred Schools<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_191_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_191' type='radio' value='Military Service (Family Relocation)'  id='choice_29_191_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_191_3' id='label_29_191_3' class='gform-field-label gform-field-label--type-inline'>Military Service (Family Relocation)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_29_192\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_192'>Provide a detailed statement with information in support of your request<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_192' id='input_29_192' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_29_193\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Acknowledgement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_193.1' id='input_29_193_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_29_193\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_29_193_1' >I acknowledge that submission of this form does not guarantee a withdrawal.<\/label><input type='hidden' name='input_193.2' value='I acknowledge that submission of this form does not guarantee a withdrawal.' class='gform_hidden' \/><input type='hidden' name='input_193.3' value='7' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_29_193' tabindex='0'> <\/div><\/fieldset><div id=\"field_29_195\" class=\"gfield 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