Office of the Registrar
Northwestern Connecticut Community College
Park Place East, Winsted, CT 06098
Save and email completed form to: kkennedy@nwcc.edu or
dzavatkay@nwcc.edu
ADD/DROP FORM
Semester: Fall 20_____ Spring 20_____ Summer 20_____
Student ID @_________________________ (REQUIRED) Date of Birth_____________
Name ___________________________________________________________________________________________
Last First Maiden / Middle Name
Mailing Address _________________________________________________ Home Phone______________________
Number and street
_______________________________________________________________ Cell Phone________________________
City, state, zip
Is this a new address: Yes No Work Phone_______________________
CRN
Course Number
Course Title
Credits
CRN
Course Number
Course Title
Credits
Instructor signature required if you are adding a course after classes have started or if course is closed.
LATE REGISTRATION OVERRIDE
CLOSED SECTION OVERRIDE
CRN#
Date
CRN#
Instructor Signature
Date
PAYMENT BY: Visa MasterCard Discover Debit Card Cash Check #_________
Card Number __________________________________________ Expiration Date ___________ Amount $__________
Cardholder’s Signature _____________________________________________________________________________
Student Signature_____________________________________________________ Date_________________
Office Use Only:
DROPPED CREDITS ________ ADDED CREDITS ________ TOTAL CREDITS ________
Registrar’s Approval _________________ Date________________
DROP
ADD
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