* Indicates a mandatory field which must be completed
Name *
Student Number *
Email *
Address *
Programme Name *
Programme Code *
Programme Year*
Last Date of Attendance * dd-mm-yyyy
Reason for Leaving * (in your own words)
Choose Reasons for Leaving * Wrong choice of programme University not suitable Programme too difficult Programme did not meet expectations Personal/Family illness Financial difficulties Felt out of place/homesick Accommodation difficulties Other
Reason for Leaving (Other) *
Plans after Leaving * Re-applying to Third Level next year No definite plans Leaving to go to work Leaving to do a PLC Course Transferring to another Third Level College Returning to sit Leaving Cert Other
Plans after Leaving (Other) *
Choice of Course * Where did you get information on the programme? Attended Open Day Career Guidance Teacher Prospectus Visiting Speaker from ITC Careers Exhibition Other
Choice of Course (Other) * Where did you get information on the programme?
Decision to Leave * I discussed my decision to leave with the following: Head of Department University Counsellor Class Tutor Friend Family Other Lecturer
All student withdrawals must be authorised by one of the Lifelong Learning Management Team *
I confirm this withdrawal was authorised by one of the Lifelong Learning Management Team
By submitting this form I am withdrawing as a student at SETU Carlow. I confirm that I have discharged all my debts to the University and that I have returned any due items to the University Library.
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