Notification of Intention to Exit Masters with a Postgraduate University Certificate or Diploma

Please complete this form if you intend to exit from your taught Masters scheme with a University Postgraduate Certificate or Diploma. To do this you will need to have taken and passed sufficient credits in the taught element or scheme. You must not have embarked on your dissertation.

Student email address

Student reference number

Surname

Forename(s)

Department

Study scheme name

Qualification type (MA,MSC)

Address to which your certificate should be sent (if different from contact address on your student record)

Postcode

Telephone

By completing this form I am instructing the University to permanently withdraw me from my course as I do not intend to submit the dissertation and would like to exit from my course with a:

University Postgraduate DiplomaUniversity Postgraduate Certificate

In doing so I confirm that I understand I will no longer be considered a registered student at the University. I have no outstanding debts owing to the University. I understand that my access to facilities will cease and that anything I have saved on the University servers that I wish to keep will have been removed and saved by me before submitting this form.