No Credit or Withdrawal Verification
Instructor/Advisor/Mentor/Supervisor: Complete this electronic form if you are awarding the student no credit for your course. A separate No Credit Verification form must be submitted for each individual course. You cannot submit one form for multiple courses. After you provide the content below and electronically sign, the document will be delivered to the Registrar's Office to post No Credit/Withdrawal to this course. You will receive a copy of the completed document via email for your records.
Name - Mentor/Instructor/Advisor
*
First Name
Last Name
E-mail - Mentor/instructor/Advisor
*
example@prescott.edu
Name of additional Mentor/Instructor
First Name
Last Name
Student and Course information
Please fill out information below
Student Name
*
First Name
Last Name
Student Middle Name
For verification purposes
Enrollment Period
*
Example: Fall 2017
Program
*
Resident Undergrad
LR Undergrad
LR M.A.
LR M.S.
SJCO
LR M.Ed.
LR Ph.D.
Course ID and Title
*
Reason for No Credit/Withdrawal
Select only one reason
For non-participation - provide date student stopped participating
For insufficient materials for evaluation (example - Student has not completed at least 75% of course work
Grade
*
No Credit
Withdrawal
Reason
*
Non-participation
Insufficient work
Other
Date
Date student stopped participating
Reason description
Signature
Submit
Should be Empty: