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Graduate Student Withdrawal Form
(GS Form G-12)
: Graduate students withdrawing from Miami University must complete this form. If you believe you qualify for a medical withdrawal, answer yes to that question and follow the instructions for completing a medical withdrawal. For additional information on medical withdrawal, visit
Effective Withdrawal Date (mm/dd/yyyy) (This is your last day of attendance and can be a past or future date.)
Semester or Term of Withdrawal (e.g., fall 2017)
Do you currently have a graduate assistantship?
Are you a combined student - simultaneously pursuing a bachelors and a master's degrees?
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