Request for University Withdrawal

(Master's and Doctoral Students) (석/박사 과정 자퇴원)

Student Name		Student ID No.
Nationality		Type of Visa (Foreigners only)State of SojournVisa Type (Non-Koreans Only)
Degree Program		Dept./Division(Major)
Address			ZipIP Code
Emergency Contact Point	☎(Home): Cell Mobile pPhone No:
Reason for Voluntary Permanent Leavepermanent leave	□ 개인사정 □ 타대학 진학(국내, 국외) ■ 세부사항 기재( ) □ Personal reasons □ Attending another college (Domestic/Foreign) ■ Describe in detail: ( □ Personal reasons(Health problems) □ Personal reasons(Official duty/Employment) □ Personal reasons(Business start-up) □ Personal reasons(Childbirth or Childbearing) □ Personal reasons(Economic conditions/Family circumstances) □ Personal reasons(Others) ■ Describe in detail: □ Attending another university (Domestic - Natural Sciences or Engineering) □ Attending another university (Domestic - Medicine or Dentistry) □ Attending another university (Domestic - Law) □ Attending another university (Domestic - Others) □ Attending another university (Abroad - Natural Sciences or Engineering) □ Attending another university (Abroad - Medicine or Dentistry) □ Attending another university (Abroad - Law) □ Attending another university (Abroad - Others) ）

I hereby request permanent academic leave.

Advisor		Department Head/ Division Chief
Name
Signature

Date(MM/DD/YY):

Applicant Name:                Signature:

Guarantor Name:                Signature:

Confirmation of the Relevant Administrative Departments

Student Classification	Requirements	Department	Staff member's name (Iindicate date)
All Students Students living in dormitory dormitories	Return of books on loan Book return	Academic Info. Management Team (Main Library, 1FACC(Library) 1F IIS Center)
	Card Key (Student ID Card), Automobile /Motorcycle identification sticker	Safety & Security Team (별도 확인 하지마세요)(Do not check separately)
	Military Reserves․/Civil Defense (Korean students only)	Reserve Forces Association (Educational Support Bldg., 2F)
	Medical treatment fees	KAIST Clinic(Medical Center 1F)
	Medical expenses	Student Scholarship & Welfare Services Team (Creative Learning Bldg.,, 12F) Relevant Dept./Division Office
	Tuition fees	Academic Registrar’s Team (Creative Learning Bldg, 1F)
	Return of dormitory supplies and key(s) Dormitory	Student Life Team (Creative Learning Bldg, 1F)
Government /(KAIST) Scholarship Students	MS Stipend (if applicable)School expenses (Master‘s students)	Scholarship & Welfare Team (Creative Learning Bldg, 2F)
	TA stipend (PhD)
	Government/KAIST Scholarship Government/KAIST Scholarship(if applicable)Benefit Repayment (repayment of student grants)	Academic Registrar’s Team (Creative Learning Bldg., 1F)
PhD Students	Related Military Services (Korean male students only)	Student Affairs Team Operations Team of the Institute for Security Convergence(N5, 2144) (Creative Learning Bldg.,, 1F)
Department Official	Dept./Division(Major): Name: Signature:		Date:

1. After completing their personal information and signing the form, the student should receive signatures from the guarantor (For Government and KAIST Scholarship students, the guarantor is the student’s legal guardian. For General Scholarship students, the guarantor is the student’s affiliating organization.), advisor, and department head. Following this, the student should submit the form to their corresponding department’s office.

2. The department/division should complete the boxes of the confirmer and person in charge of the confirming departments (for the return of borrowed items, the applicant him/herself directly confirms with the relevant department.) after confirming with the relevant departments by phone or fax, and after the form has been completed fully, the student should submit the form to the Academic Registrar’s Team

※ Before the final submission of the form to ART: matters related to “repayment of student grants“ should be handled in advance with the Academic Registrar’s Team

3. Any change in an international student’s visa status must be reported to the immigration center. Students must fill out the blank for nationality/visa type. (If the student has not reported his/her nationality to the Academic Registrar’s Team, submit a copy of students’ Alien Registration Card and Passport with this form).