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Exceptional Circumstances Withdrawal Form


Exceptional Circumstances Withdrawal Packets submitted, are for all courses and should be submitted during the semester for which the withdrawal is requested and at least two (2) weeks prior to the last day of classes. Incomplete packets will not be processed. Applications received after the submission deadline may be considered only if the student's documents show that the failure to apply in a timely manner was beyond the control of the student.

Qualifying Reasons for an Exceptional Circumstances Withdrawal are:
A. Physical/Mental Illness or Injury: Illness of a student of such severity or duration, to preclude completion of all courses.
B. Death of an immediate family member (parent, step-parents, spouse, child, sibling, or grandparents) (papers required).
C. Involuntary call to Active Military Duty (requires copy of military orders).
D. Primary Care-Giver to ill Immediate Family Member–(Refer to Item B above for immediate family list)
E. Victim of Crime
F. Other (circumstances that directly effected your ability to complete all classes, and that was out of your control)

Complete Packet Includes:
1. Request for Exceptional Circumstances Withdrawal Form: The student is required to complete and submit this form online.
2. Letter of Explanation: A letter, written, signed & dated by the student, explaining the reason for the withdrawal request.
3. Release of Medical Information (if applicable): The student is required to complete and sign the form.
4. Acceptable documentation for one of the following:

Physical/Mental Illness or Injury:

  • Physician / Clinician must complete the Medical Certification Form provided by FAU. This form must be completed in its entirety for submission.
  • Physician / Clinician must state that condition prevents successful completion of all courses and the reason(s) why.

Death in Immediate Family :

  • Requires Death Certificate, a letter from funeral director, or obituary.
  • International documents must be translated to English for submission

Military:

  • Requires copy of Military Orders

Primary Care-Giver to ill Immediate Family Member:

  • Physician/Clinician of Family Member must complete the Primary Caregiver Certification Form provided by FAU. This form must be completed in its entirety for submission.
  • The reason(s) the family member’s condition prevents the student’s successful completion of all course work.

Victim of Crime :

  • Letter from Victim Advocate and/or Police report
  • The reason(s) the crime prevents the student’s successful completion of all course work.

Other:

  • On a per case basis
  • Relevant documentation required


Procedure:

Completed forms will be submitted to the Exceptional Circumstances Withdrawal Committee (ECW) for review. The ECW Committee, which is made up of university employees and includes healthcare professionals, meets weekly and will determine if there is just cause for a withdrawal due to exceptional circumstances.

In ALL cases of Physical / Mental Illness or Injury Withdrawals, an administrative hold may be placed on the student's upcoming registration until clearance is given by the attending physician / clinician, in writing, indicating that the student is now well enough to return to school. The ECW Committee will review the documentation and determine whether or not the student can resume classes for the upcoming semester. Details regarding the required documentation are attached to the ECW approval letter sent to the student.

If the withdrawal is approved, a "WM" will replace the grades. Documentation must be in English, or be translated to English, and the translator's signature must be notarized. The translator must be someone other than the student or a relative of the student.

If the withdrawal is approved and the student resides on campus, they must move out within 48 hours of receiving the approval letter. 

Student Appeal Process:
Students who are denied an Exceptional Circumstances Withdrawal may appeal the decision to the VP of Student Affairs, in writing, within ten (10) days of receipt of denial letter.

It is important that you refer to the "University Regulation 4.013" for the complete policy on Exceptional Circumstance Withdrawals. The policy includes important information about potential implications for financial aid, on campus housing and meal plan contracts.

General Information

Incomplete forms will not be processed.

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First and Last Name
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ECW Applicant Information

Please provide Basic Information about the Student Requesting ECW

Involved party 1

Withdrawal Information

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Supplemental Questions (Select all that apply)
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Supporting Documentation


Upload all Required Documentation to support your application for Exceptional Circumstance Withdrawal:
- Letter of Explanation (required)
- Release of Medical Information Form (If applicable)
- Supporting Documents (see specific information at top of page)

You may upload a PDF of your documentation or provide a photo file of the documents such as jpg, bmp, or png
5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission