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Withdraw My Admission Offer
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This form is intended for
admitted students only
. If you have submitted an application for admission but have not been admitted, please email the Office of Admissions at
admission@missouristate.edu
to withdraw your application.
By completing and submitting this form, you are withdrawing your application for admission to Missouri State University and cancelling your intent to enroll as a student. Submitting this form also serves as a refund request for the $150 enrollment deposit and $100 housing deposit. To receive a refund, this form must be submitted on or before May 1.
*
Required field
Student Identification
Student First Name
Student Preferred First Name
Student Last Name
Student Date of Birth
Student Date of Birth
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BearPass Number
Student Email Address
Reason for Withdrawal
We're sorry to learn you won't be attending Missouri State University. Thank you for letting us know. We wish you the best!
What will you be doing instead?
What will you be doing instead?
Attending a 2-year community college
Attending a 4-year college or university
Enlisting in the military
Entering the workforce
What are the primary factors in your decision not to attend Missouri State at this time?
What are the primary factors in your decision not to attend Missouri State at this time?
Academic Program
Athletics
Financial Aid
Location
Deposits
Have you submitted the $100 deposit for the housing contract?
Have you submitted the $100 deposit for the housing contract?
Yes
No
Unsure
Please note:
The deadline to request a refund of the $100 housing deposit is May 1.
Have you registered for a SOAR session?
Have you registered for a SOAR session?
Yes
No
Unsure
If you were admitted for the fall semester, have you paid the $150 enrollment deposit?
If you were admitted for the fall semester, have you paid the $150 enrollment deposit?
Yes
No
Not applicable; I am admitted for the Spring or Summer semester.
Not applicable; I am a transfer student (with 24 or more transferrable credit hours earned AFTER high school graduation).
Not applicable; I am an adult student.
Please note:
The deadline to request a refund of the $150 enrollment deposit is May 1. Further details about the enrollment deposit and its refund policies can be found
on our website
.
My enrollment deposit was originally paid by:
My enrollment deposit was originally paid by:
Credit/debit card
Electronic check (or e-check)
Check, money order, or cash
Unsure
Enrollment Deposit Reference Number
Acknowledgements
I acknowledge that my application for admission will be withdrawn and my SOAR reservation will be cancelled upon submission of this form.
I acknowledge that my application for admission will be withdrawn and my SOAR reservation will be cancelled upon submission of this form.
Yes
I acknowledge that the $150 enrollment deposit is
nonrefundable
to those who withdraw their application for admission after May 1.
I acknowledge that the $150 enrollment deposit is
nonrefundable
to those who withdraw their application for admission after May 1.
Yes
I acknowledge that the $100 housing deposit is
nonrefundable
to those who withdraw their application for admission after May 1.
I acknowledge that the $100 housing deposit is
nonrefundable
to those who withdraw their application for admission after May 1.
Yes
Select the
Submit
button to process your request.
Submit