Withdrawal Request Form

Please Note:

This form is to be used ONLY if you wish to withdraw from your program at Niagara College Welland or Daniel J. Patterson (formerly Niagara on the lake) Campus.

If you require assistance in withdrawing from Niagara College – Toronto, please visit the following webpage for further information and guidance: https://www.niagaracollegetoronto.ca/admissions/withdrawal-refund-process.

Personal Details

Student Number

Date of Birth

MM/DD/YYYY

Citizenship Country

Full Name

Email Address

Phone

Other Information

Current Location

Do you have a valid study permit?

Did you use an agent to apply?

Select Program Type

Post Secondary Program

EAP Program Name

Term you are withdrawing from

Start typing Year and select from list

Reason for withdrawal

Note:

If approved as a withdrawal based on a visa/study permit refusal, a $200 administrative fee will be deducted from the refund amount.

Please explain

Upload Documents Instructions

Please upload supporting documents using the links provided for each document.

Be sure to upload all mandatory documents otherwise, you will not be able to submit your application.

Please ensure each uploaded document is not larger than 500KB.

Bio Page of your Passport (Page Must Contain Signature)

Study Permit

Letter of Acceptance at new Institution

Proof of Payment of the first academic term of the new Institution

Confirmed Flight/Airline Ticket (if leaving Canada)

Visa Refusal Letter from IRCC

Certificat d'Acceptation du Quebec (Quebec Acceptance Certificate, CAQ)

Only applicable if going to Quebec for Study

Disclaimer

By submitting this form, I hereby declare that the information contained is true and I authorize Niagara College Canada to process my withdrawal in accordance with the applicable policy for my withdraw request as outlined on the college website: https://international.niagaracollege.ca/withdrawal-refund-process/.

The submission of this form indicates I have fully read and understood the terms and conditions and accept.

Click to Agree

I agree

Contact Information