Application for Withdrawal

Students submitting this application should ensure they have read and understood CPLED’s policies. This form should be used to request a permanent withdrawal from a student’s program. Requests from students who require an extended absence but intend to return to the program should be addressed by way of an Application for Deferral.

Name*
First Last
Email*
Phone*
I request to permanently withdraw from the following program:*
- PREP
- LRW
I request to withdraw from my program with the effective date (YYYY-MM-DD):*
I request to withdraw for the following reasons: (optional)
Additional Information (attach a separate sheet if required):
Additional Information
Max. file size: 320 MB.
I confirm that I have read and understood the requirements of this form and any relevant CPLED policies. I affirm that all the information and documentation provided in support of this application are accurate and true. I understand that CPLED may request further information and documentation from me in support of my application. For the purposes of verifying authenticity, I authorize CPLED to contact anyone who provided documentation submitted in support of this application, including but not limited to medical documentation.*
First & Last Name

Application for Withdrawal

Questions?

Contact us at admin@CPLED.ca