Withdrawal Notification Form for VA/Military Benefits

Withdraw Notification Form

Personal Information


If "Yes," this form needs to be filled out and submitted to registration for complete withdrawl. Complete Withdrawal Form
By submitting this form, I acknowledge the following:

1. I am responsible for payment of my tuition and fees not paid by my GI Bill benefits.
2. The only registered classes that can be certified are those that fall within my degree plan.
3. It is my responsibility to notify the Veterans Coordinator if I add or drop a class. (including block classes)
4. I can be purged for non-payment of tuition if I have an outstanding balance with Dixie State University

If No, Click on the button below.