Bismarck State College
Collaborative Withdrawal/Drop Request Form
Bismarck State College, P.O. Box 5587, 1500 Edwards Avenue, Bismarck, ND 58506    701-224-5400 :: 800-445-5073
These are the steps that you will need to complete to withdraw/drop as a collaborative student:
  1. Complete the Collaborative Withdrawal/Drop Form below.
  2. After BSC receives your request, we will forward it to your provider college.
  3. You will receive a confirmation email within 2 weeks after withdrawal/drop has been completed.
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* First Name:
* Last Name:
* EMPL (Student) ID: 
* Daytime Phone:
* Email Address:
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* Semester you wish to withdraw/drop for:
* School that you are withdrawing/dropping course from. (You need
to complete/submit a collaborative form for each school)
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* If withdrawing from all Collaborative classes, are you also withdrawing from Bismarck State College? (If yes, a separate withdraw/drop form must be completed) Yes No
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* Are you receiving financial aid for this semester? Yes  No 

Collaborative Request #1

 

Class #:
Course Title:
Subject and Catalog #
(i.e. ENGL 110):

Collaborative Request #2

 

Class #:
Course Title:
Subject and Catalog #
(i.e. ENGL 110):

Collaborative Request #3

 

Class #:
Course Title:
Subject and Catalog #
(i.e. ENGL 110):

Collaborative Request #4

 

Class #:
Course Title:
Subject and Catalog #
(i.e. ENGL 110):

* Signature:   I have read and understand all criteria as presented on this page. I certify that all statements on this
                         form are true to the best of my knowledge.
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