Office of the University Ombuds

Non-attendance Withdrawal Appeal Form

Below you will find the instructions and fillable online form for the non-attendance withdrawal appeal. This form may also be downloaded and filled out in hard-copy format (Word document) here.

Instructions

Complete the online form below or hard-copy form above. If appealing for more than one semester, a separate form is required for each semester.
Be sure to affirm or deny the non-attendance statement at the bottom of the online form. If you wish to submit the hard-copy form, be sure to sign and date the form to confirm that you never attended, participated in or contributed to the courses in question. Hard-copy non-attendance withdrawal appeal forms may be dropped off in person at the Office of the University Ombuds or sent by email, fax or standard U.S. mail. Our contact information is:
Office of the University Ombuds
1903 W. Michigan Ave.
Kalamazoo, MI 49008-5295 USA
ombuds@wmich.edu
Fax: (269) 387-0716
Results of the appeal will be sent to you via the email address you provide. It is strongly suggested that students use their wmich.edu student email address if possible.

Contact information

Name (required)

E-mail address (wmich.edu email address preferred) (required)

Phone

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Date of request (required)

WIN (required)

WMU Identification Number

Did you ever attend, participate or contribute to this course, even once? (required)

Yes

Have you consulted with Financial Aid/your funding source? (required)

Yes

N/A

Have you consulted with International Admissions and Services? (required)

Yes

N/A

Semester you took the course in question (required)

Fall

Spring

Summer I session

Summer II session

Year you took the course in question (required)

Courses (required)

Re-order	Department	Course number	Weight	Operations
	Department	Course number	Item weight

more items

I certify that I have not attended, participated or contributed to the courses in question for this appeal. (required)

Affirm

Deny

By engaging in the non-attendance withdrawal appeal process, I give WMU and the Office of the Ombudsman permission to share submitted materials with the instructors of records and academic departments in question for the courses listed above. If approved, I give the Office of the Ombudsman permission to share the results with the Registrar’s Office. (required)

I agree

I disagree

Office of the University Ombuds
Western Michigan University

1903 W.Michigan Ave.
Kalamazoo MI 49008-5295 USA
Phone: (269) 387-0718
Fax: (269) 387-0716
Email: ombuds@wmich.edu

Location
2420 Faunce Student Services Building, Mail Stop 5295