CCPS Withdrawal Request SI Header Image

CCPS Staten Island Withdrawal Form

For Fall 2021:  Students can continue to make schedule changes through UIS until Wednesday, September 8.

After September 8, CCPS students should use this withdrawal form to request a course be dropped or withdrawn from their schedule. Note the important deadlines for Fall 2021

The last day to drop a class without a transcript notation for Fall 2021 is Tuesday, September 21, 2021

The last day to withdraw from a course for Fall 2021 is Monday, November 8, 2021

Part 1: Student Information

Student Instructions: Fill out all portions of this form.

Please note:

  • The date and time this form is sent is the date that will be used for the WD.
  • You must be enrolled in at least 12 credits to be considered a full time student.
  • It may take up to 3-5 Business Days for it to be reviewed.
Student's Name*

Part 2: Withdrawal

How many classes would you like to be withdrawn from? *
  • Course Subject Number (Example: MGT 1001)
    • CRN (five digit course registration number- found on your schedule.)
      • SPRING CRNs begin WITH “1”
      • SUMMER CRNs begin with “3”
      • FALL CRNs begin with “5”
      • WINTER CRNs begin with “8”
  • Credits (Example:  3)

Student Signature

Use your mouse or finger to draw your signature above

Part 2A: Credit Calculation


THIS IS A COMPLETE WITHDRAWAL (You may be contacted by the Dean's Office, before processing).


Your total credits after withdrawal are less than 12. In order to be a full time student, you must be enrolled in at least 12 credits. If this withdrawal brings your credit load below 12 credits, you should check with financial aid ( or 718-990-2000 ) to determine how your aid/scholarships may be affected before submitting this withdrawal request.

Part 3: Select Your Advising Dean

Select an Advising Dean from the list below and input their name here.*

Advising Deans List

Assisting Students with Last Names Beginning:

Advising Dean:

St. John's E-mail:

A – L
M – ZProvidence

By Submitting this Form: I understand that if my enrollment drops below 12 credits I will be a part time student.  I have contacted Financial Services to determine how my scholarship and aid has been affected.

Part 4 - Advising Dean Review/Approval:

Do you Approve the student's Withdraw Request?*
(Optional) Dean Signature
Use this option if the Dean who is signing is not the Dean selected:
Name of "Signing" Advising Dean*
Use your mouse or finger to draw your signature above
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