UNIVERSITY OF GONDAR

University of the Registrar

Student Clearance/Withdrawal Form

Academic Career: Undergraduate

Admit Type : REG

PURPOSE:
If it is necessary for a student's relationship to the university to be terminated it is important to him/her that he/she completes withdrawal procedures so that he/she may be issued
documents showing clearance of his/her responsibility to the university. Only with the proper termination below can grade reports, letter of enrolment or honorable dismissal be issued.
Readmission to any unit of the university including any university extension unit will be considered only if the university Registrar certifies proper termination.

PROCEDURES:
1. Complete the first part of this form
2. Have terminal interviews with your Faculty Advisor, your academic Dean and with the Dean of Students, obtaining their signature below.
3. Obtain the other signatures designated, showing that you have returned university property and are clear with the Business Office.
4. Return this form to the office of the registrar, not later than two weeks after your absence from class has been reported by your instructors. This form becomes part of your
permanent university file and record.

Name: TSEDENAYIT YARGEAL ASFAW Student ID: 00000028668

Program: Bachelor of Science Engg Plan: Civil Engineering
Academic Year: 2018 Term: 1820 : UG Reg 2nd year & Above
Gender: Female Campus ID: GUR/6014/08
College/Faculty/School: Institute of Technology Department: Civil Engineering
Reason for Clearance: End of Academic Year. Date Requested:Sunday, March 10, 2019

SeqNo Approver Role Approver Name Approved Comments

1 UOG_HOD_CIVILENG YOHANNES.HAILEMARYAM Yes
2 U_LIBRARY_ADMIN_FASIL DESTA.ZEYESUS Yes
3 U_DORMITORY_ADMIN_FASIL SEFIW.HAILEMARIAM Yes
4 U_CAFETERIA_ADMIN_FASIL HABTU.ESHETIE Yes
5 U_ASSO_STDNT_DEAN_FASIL EYOB.SOLOMON Yes
6 UOG_AR_SENG TIBEBU.TAKELE Yes

Print Date Time: 3/12/2019 18:54:51 PM

End of Report
Generated By: TSEDENAYIT.YAR1

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