Policy Withdrawal Request

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Before you submit this request, obtain approval from the Responsible Cabinet Member listed at the end of this form.

POLICY NAME AND LOCATION
Policy Name *
Maximum of 100 characters allowed. Currently Entered: 0 characters.
Link to existing policy (or attach pdf, if not found on our policy webpage) *
Upload a File

Attach Files
EFFECTIVE WITHDRAWAL DATE
Date on which policy should be withdrawn from public view Date on which policy should be withdrawn from public view * / MM / DD YYYY
REQUESTOR'S CONTACT INFORMATION
Name Name * First Last
Email *
Contact Phone Contact Phone * - ### - ### ####
Division *

Division Academic Affairs Administration & Finance Advancement & Communications Enrollment Management Student Affairs
Department or Unit *
REASON FOR WITHDRAWING THIS POLICY
List Reasoning (i.e.: State mandated, covered by another policy, etc.) *
Maximum of 350 characters allowed. Currently Entered: 0 characters.
If another policy(ies) or guideline(s) is/are to be used after this policy is withdrawn, please provide the link(s)
Enter Link
Enter Link
APPROVED BY Responsible Cabinet Member
Select appropriate Responsible Cabinet Member after they have given their approval *

Select appropriate Responsible Cabinet Member after they have given their approval Provost / VP for Academic Affairs VP for Administration & Finance VP for Advancement & Communications VP for Enrollment Management VP for Student Affairs