ADD / DROP CLASS FORM
University of North Texas Health Science Center
Office of the Registrar, SSC 240
3500 Camp Bowie Blvd.
Fort Worth, TX 76107-2699
(817) 735-2201 / Fax (817) 735-0448
registrar@unthsc.edu
Questions regarding data collected may be directed to the Registrar. (HB 1922)
Student ID OR Social Security Number
Last Name First Name Middle Name
Date of Birth
Daytime Telephone Number
E-mail
Program
SPH GSBS Pharm
International Student?
YES NO
ADD CLASS: List all courses you wish to add.
See Academic Calendar for registration periods and the last day to add classes.
Department
(EXAMPLE) BACH
Course
(EXAMPLE) 5310
Title
(EXAMPLE) Community Assessment
DROP CLASS: List all courses you wish to drop.
Approval for drop required after last day to receive automatic W. See Academic Calendar for details.
Course
Title
Instructor Signature
Grade
(Instructor Only: Check one)
W (Withdrawal)
WF (Withdrawal Failing)
W (Withdrawal)
WF (Withdrawal Failing )
IF DROPPING A CLASS, RETURN THIS FORM TO THE OFFICE OF THE REGISTRAR & PLEASE READ BELOW:
It is your responsibility to consult your advisor before dropping any class.
A class dropped before the census date will not appear on the transcript. A class dropped after the census date will appear
on the transcript & be assigned a grade of W or WF.
Refunds:
o
If the last class of a session (8 week 1, regular, 8 week 2) is dropped, it is subject to the complete withdrawal
refund schedule.
o
If a class is dropped but the student is enrolled in another class during that same session, the student will receive
100% refund if the class is dropped before the census date.
You cannot drop your only remaining class using this form during a long semester (fall or spring).
o
If all classes are dropped during a long semester, it is considered complete withdrawal or leave of absence. You
must pick up the withdrawal/leave of absence form in person at the Office of the Registrar. SPH online certificate
students are exempt from requesting a leave of absence.
_
Student Signature Date
Please allow 24 hours for processing
For Office Use Only
Revised 03/13/2017 Date request completed
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click to sign
signature
click to edit
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