Bismarck State College
Withdraw to Zero Credits Form
Bismarck State College, P.O. Box 5587, 1500 Edwards Avenue, Bismarck, ND 58506    701-224-5400 :: 800-445-5073
The Withdraw to Zero Credits form can ONLY be used if grades (A-F) have not been earned in any courses and if ALL courses fall within the Last Day to Drop/Withdraw deadline.

If you are currently on a waiting list for any limited programs, contact Admissions at 701.224.5429. If you do not contact Admissions you will FORFEIT your position and your name will then be removed from the waiting list.

If you plan on returning to BSC, you must complete an Admission Application online at http://www.bismarckstate.edu/future/. If you are withdrawing from the summer semester and would like to attend the fall semester or are currently enrolled in fall classes you will not need to reapply with Admissions.

    DIRECTIONS--
  1. Type your information into each field, check the signature box, and click the submit button at the bottom of this form.

  2. Upon receiving the form in Academic Records, it will be forwarded to the proper offices to ensure all student obligations have been met. This process may take up to 10 working days. Once all offices have cleared the student for withdrawal, a confirmation will be sent to the student. The withdrawal date posted on the student's record and all refunds will be based on the date the initial form was received in the Academic Records Office.

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If you wish to receive an email confirmation, enter your email address above.
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*Have you lived in BSC housing this term? Yes No
*Do you receive GI Bill benefits? Yes No
*Are you a collaborative student? Yes No
If yes, who is your home institution?
* Withdrawal to Zero Credits Semester:
Summer Fall Spring* Withdrawal Year:                
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       *I plan to return to BSC:   Yes No    If yes, when?
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If you plan on returning to BSC, you must complete an Admission Application online at http://www.bismarckstate.edu/future/.

If you are withdrawing from the summer semester and would like to attend the fall semester or are currently enrolled in fall classes you will not need to reapply with Admissions.

* Reason for Withdrawal:
Must Complete the Explanation Below
  Transferring to another college Moving to another location
  Undecided on program of study Dissatisfied with my grades
  Needed a break from college Job conflict/Accepted full-time position
  Personal/Family reasons Financial reasons
  Academic advising inadequate Dissatisfied with quality of instruction
  Unaware of class progress/grades Other
  Desired major was not offered by this college     What major?

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* How would you prefer to be contacted about your withdrawal?
 
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* * Required Fields
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* I accept all academic and financial consequences resulting from this withdrawal. I understand that I am subject to charges and refunds according to State Board of Higher Education policy. I understand that withdrawing may have an impact on future financial eligibility. Check this box:
* I certify to the best of my knowledge that the information on this form is true and complete without evasion or misrepresentation. I understand that if found to be otherwise, it is sufficient cause for rejections or dismissal. By checking this box you have created an electronic signature as legal as your handwritten signature.