CoROM Withdrawal Form Name(Required) First Last Email Address(Required)Please give us the best email address to contact you with in the future. (Not your CoROM email address.) Which programme are you enrolled in?(Required) BSc Remote Paramedic Practice MSc Austere Critical Care Masters in Global Health Leadership Why are you leaving this programme?(Required)Is there anything that the CoROM could have improved during your enrolment? ------ here is room for additional details.Declaration of WithdrawalBy agreeing to withdraw from this programme, I understand that I am not entitled to any tuition refund. I release and hold harmless the College of Remote and Offshore Medicine Foundation from any claims regarding my enrolment in this programme. I understand that I am allowed to reapply to this programme at a later date, and my past work will be considered when reentering the programme. I agree to withdrawal from this programmePrivacy(Required) By using this form you agree with the storage and handling of your data by this website. *