Student Exit Interview

This Exit Interview form is to be completed by any student who plans to complete this semester, but will not be returning to William Jewell for the next semester. This form is developed for your convenience. It is designed to:

  • assist you in exiting the College and to help you understand the expectations associated with your exit.
  • assist William Jewell in evaluating efforts to meet the needs of the student body.

Residential students must complete this form in order to receive room deposit refund. Please know that any information shared will remain confidential and only the student name will be distributed to offices on a need-to-know basis.

Note: All fields marked with an * are required.

Student Information
First Name *
Last Name *
Jewell E-mail Address *
Are you a Commuter or a Residential student?
Social Security # *
Gender Female Male
Race *
Religious Preference
First generation college student? Yes No
Premanent Address *
City *
State   Zip *

Class Status
First-Year
Sophomore
Junior
Senior
Graduate

Current Program
B.A. or B.S. (scroll for major) *

Activities you were involved in (please check all that apply)
CUA
Greek Organization
CSM
Athletics
BSA
Unity
Intramurals
Honors Organization
Language Organization
Other

Is there a faculty/staff/administration member that you developed a significant relationship? Yes No
Reasons for Leaving Jewell
Please help us to understand the circumstances supporting your decision to leave William Jewell. You may check all that apply.
Transferring to: (required only if transferring)
School *
City or Town *
To major in *
Reason for transfer *
Residence Hall Experience (please explain)
Personal (please explain)
Medical Reasons (please explain)
Financial Reason (please explain)
Campus Climate (please explain)
Adjustment Issues (please explain)
Military
Academic Difficulties
Other (please explain any other reason that has influenced your decision to leave William Jewell) *
Do you plan to return to William Jewell in the future? Yes No
If yes, please specify the semester and the year.
Was it ever your intention to complete your education (earn your degree) at William Jewell? Yes No
Are there ways Jewell could have better served you? Please be specific.

Check out Procedures:
  • If you have registered for next semester, please be sure to cancel your registration through the Registrar’s Office.
  • Residential Students need to follow the Residence Hall Check-Out Policy. Must do this through an RA or your RD.