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Student Information
Student Name:
Banner ID:
Enrollment/Admission Cancellation
What institution?
What do you plan to study (major) at college?
How many institutions did you apply to?
At the time of application, what were your top three choices?First Choice: Second Choice: Third Choice:
Why did you apply to Northwest?
Semester you plan to enter Northwest: - Select -
Housing Cancellation
Recruit/Prospect Cancellation
City:
State: - Select - Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
The student must contact the Student Success Center at 660.562.1695.
Administrative Use
Date of Drop:
Took the Call:
Comments: