Free Course Dropout Template
Ask withdrawing students what made them leave, when they decided, and what would have kept them - so the next cohort is designed against the real reasons.
Quick answer
Ask withdrawing students what made them leave, when they decided, and what would have kept them - so the next cohort is designed against the real reasons.
About this template
Withdrawal reasons are usually guessed from the week people stop showing up. This exit survey asks the learner who left to name the reason, the point at which they decided, whether anyone noticed, what they were going to do instead, and the single change that might have kept them. Answers are grouped by cohort, so the pattern - cost, time, difficulty, a missing support contact, or a schedule mismatch - becomes a design decision instead of a theory.
Live Preview
Fillable sample course dropout preview - fields and options you can adjust before you publish.
What's Included
Everything you need to run this template.
Reasons as categories
Fixed codes match the retention levers you can pull.
The moment, not just the fact
Knowing when they decided shows where the signal was lost.
Was anyone watching
A noticed-or-not question tests your outreach honestly.
One change, required
Each exit produces a candidate fix, not a complaint.
How It Works
From copy to deliverable in four steps.
Write the statements and scale
Copy it in and set reason codes to match your levers.
Invite at withdrawal
Send the link when the learner pauses or drops, without pressure.
Group by cohort
Read reasons and decision points per intake.
Change one lever
Fix the top reason, then watch the next cohort's exits.
Who Is This For
Pick your role — see how it fits your workflow.
Course creators
Find the week where learners slip away.
Student support teams
Test whether outreach actually happened.
Retention and program leads
Argue for budget with named exit reasons.
Key Features
What makes this template work as a professional deliverable.
- Fixed reason categories matching your retention levers
- Point-in-course when they decided to leave
- Whether anyone noticed or reached out
- Alternative they chose instead
- One change that could have kept them
- Re-enrollment interest captured honestly
Sample Questions Inside
A preview of the real fields and prompts - adjust wording, options and length to your own process.
- What was the main reason you stopped? (select)
- At what point did you decide to leave? (open)
- Did anyone from the course notice or contact you? (yes, no, not sure)
- What are you doing instead of continuing? (open)
- What one change might have kept you? (required)
- Would you consider re-enrolling later? (yes, no, maybe)
- Anything else we should know (optional)