All students leaving PSUAD must obtain clearance and signature from the following departments before receiving any transcript, degree or official certificate from Admissions.

STUDENT DETAILSName:Major:Telephone:Student ID:Reasons For Clearance: Graduated Withdrawn Dismissed

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Student Clearance Form

DEPARTMENTS CLEARANCEHEAD OF DEPARTMENT/COORDINATOR (only in case of withdrawal)

Last day of attendance:Name & Signature:Date:

LIBRARY (Please verify that all library materials/fines have been returned/paid) Ground floor, office #7.006 (see reverse)

Name & Signature:Date:

IT DEPARTMENT (for withdrawal and dismissal cases only) First floor, office #2.150 (Please verify that student’s email address has been disabled)

Name & Signature:Date:

CULTURAL AND STUDENTS SERVICES Visa and Insurance (only for students under PSUAD visa) First floor, office #2.134

Name & Signature:Date:

STUDENT HOUSING Buildings 9 and 10 (see reverse)

Not in the Residence Student left with no damages Student left with damages*Academic Year:*Amount (in AED): Name & Signature:Date:

sorbonne.ae

Student Clearance Form

RECEPTION OF THE SPORTS BUILDING Building 8

Name & Signature:Date:

FINANCE DEPARTMENT First floor, offices #2.117 - #2.118 (Please verify that all financial indebtedness to PSUAD has been cleared and any refund, if any, has been made)

Name & Signature:Date:

REGISTRAR DEPARTMENT/ADMISSIONS SECTION Ground Floor office #2.051

Name & Signature:Date:

DEGREE RECEIVED BY STUDENTI, hereby certify that I have received my degree from Admissions.Address:Telephone:Email:

REASONS FOR WITHDRAWAL TO BE CLEARLY STATED BY THE STUDENT