Administrative Withdrawal Due to Class Disruption Form

For academic department use only

This form is used by the instructor to request an administrative withdrawal of a student due to class disruption.

Do not return this form to the Office of the Registrar. The original copy must be submitted to the Associate Provost for Faculty and Academic Affairs. A copy of the completed form should be kept in the department office.

Download Administrative Withdrawal Due to Class Disruption form fillable PDF updated 3/31/15

Download Administrative Withdrawal Due to Class Disruption form Word version updated 3/31/15


University policy

Op3.04-11 Class Disruption

The course instructor has original jurisdiction over his/her class and may deny a student who is unduly disruptive the right to attend the class. The student is expected to comply with all reasonable directives of the course instructor. The course instructor may have a student administratively withdrawn from a course upon showing of good cause and with the concurrence of the department head. The appeals process in case of such administrative withdrawal shall be as stated in the Grade Appeals and Academic Grievances policy.

Additional Policy Effective August 1, 2016

Mixed Credit (Accelerated Graduate Programs): Students admitted into an approved accelerated graduate degree program may have a limited number of 600-level or higher courses counted toward both an undergraduate and graduate degree.

Mixed Credit (General): Undergraduate students who meet all the admission requirements of a graduate degree or certificate program other than the completion of a baccalaureate degree may receive permission to take up to six hours of mixed (undergraduate and graduate) credit without first being admitted to a specific graduate program.

Senior Permission: Undergraduate students who have accumulated at least 90 hours from Missouri State or another accredited institution may be permittedto take a maximum of 12 credits of 600-level or higher courses for graduate credit.

For additional information, please review the entire policy.

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