Self-Paced Online Courses Withdrawal Request

This form is for current self-paced online students only. Prior to submitting this form, please be sure to have read information pertaining to refunds on the self-paced online course website.

Please use the following form to withdraw from your self-paced online course. Requests must be made via this form. In order to ensure prompt processing, please provide all information requested below.

If you have any questions, please contact Online & Distance Education at 319-273-7206 or

Click "Add another response" below to drop multiple courses.