Withdrawal Request

"*" indicates required fields

Are you withdrawing from all Navigate-NIDES courses/programs?*

Yes, I would like to withdraw from all my NIDES courses

No, I only want to withdraw from 1 course

Course List:*

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Course

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Teacher Email:

Student Legal Name*

First Last

Student Date of Birth*

Student Email*

Reason for Withdrawal:*

Explain Reason for Withdrawal:*

This field is for validation purposes and should be left unchanged.