THE SCHOOL OF GRADUATE STUDIES IN THE HEALTH SCIENCES
ADD/DROP REQUEST
Name Effective Date of Change(m/d/yr)
Student # Program Year
Circle Semester: Fall Spring Summer
ADD (Additional hours must be paid for at the time of change or late charges will be assessed)
Course Name Course Number Section Hours
Course Name Course Number Section Hours
Course Name Course Number Section Hours
Number of registered hours before addition of course(s):
DROP
Course Name Course Number Section Hours
Course Name Course Number Section Hours
Course Name Course Number Section Hours
Number of registered hours before dropping course(s):
I request that these changes be made (signature of student)
APPROVED GRADUATE
Program Director
Professor/Course Added
Dean School of Graduate Studies