Fillable Add-drop-form Add / Drop / Withdraw Registration Form (South Puget Sound Community College)

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Add-drop-form Add / Drop / Withdraw Registration Form (South Puget Sound Community College)

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1
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I I I H I H I I I I
I I I
H I H I I I I
REGISTRATION FORM Add/Drop/Withdraw
Enrollment Services
2011 Mottman Rd SW Olympia, WA 98512
www.spscc.edu
Ph. (360) 596-5241
enroll@spscc.edu
Quarter
Running
Start?
(check box
below)
Gender
☐ Summer
☐ Fall
Year
Today’s Date
☐ Male
Birthdate
☐ Winter
☐ Spring
☐
☐ Female
Student ID Number
Social Security Number **
To comply with federal laws, we are required to ask for your Social Security Number (SSN) or Individual Taxpayer Identification
Number (ITIN). We will use your SSN/ITIN to report payments made by you that may qualify for a tax credit or a tax deduction on your
income tax return. We may also use this information to administer state/federal financial aid, to verify enrollment, degree and academic
transcript records, and to conduct institutional research. If you do not submit your SSN/ITIN, you will not be denied access to the
college; however, you may be subject to an IRS penalty of $100. Pursuant to state and federal law, the college will protect your SSN
from unauthorized use and/or disclosure.
Last Name
First Name
M.I.
Signature
Check this box and complete the back side of this form if you want to update your information with Enrollment Services.
☐
If you are receiving Financial Aid, you will need to complete a separate change of information form to update your address or phone number.
Registration forms will be accepted in person with picture identification or this form may be scanned and emailed to enroll@spscc.edu, but will ONLY be accepted if it is sent
from the student’s my.spscc.edu email address. Submissions from personal/business email addresses will not be accepted.
ADD
View the current class schedule online at http://www.spscc.edu.
DROP
The instructor’s signature is required to audit a class or to override the capacity or prerequisite of a class. Beginning on the third day of the quarter,
the instructor’s signature is required to add any class (excluding late start classes), and the Division Dean’s signature is also required to override the prerequisite of a class.
Item #
Class
Credits
Instructor Signature
Dean Signature
Reason(s) – Check all that apply.
Item #
Class
Credits
☐ Audit
☐ Capacity
☐ Prerequisite
☐ Audit
☐ Capacity
☐ Prerequisite
☐ Audit
☐ Capacity
☐ Prerequisite
☐ Audit
☐ Capacity
☐ Prerequisite
☐ Audit
☐ Capacity
☐ Prerequisite
☐ Audit
☐ Capacity
☐ Prerequisite
☐ Audit
☐ Capacity
☐ Prerequisite
☐ Audit
☐ Capacity
☐ Prerequisite
See Reverse Side For Optional Information
I I I I
I I I I I
I I I I I
I I I I I
I I I
Optional: Change of Address/Phone Number
Complete this section to update your address/phone with Enrollment Services. Complete a separate change of information form to update your information with Financial Aid.
Street Address
Apt #
City
State
Zip Code
Cell Phone
Home Phone
Optional: Biographical Data
1. How long do you plan to attend SPSCC?
☐ 1 quarter [11]
☐ 2 quarters [12]
☐ 1 year [13]
☐ Up to 2 years, no degree
planned [14]
☐ Long enough to
finish a degree [15]
☐ Don’t know [16]
☐ Other [90]
2. Work status while attending college?
☐ Full-time homemaker [11]
☐ Full-time
employment [12]
☐ Part-time off
campus [13]
☐ Part-time on campus [14]
☐ Not employed,
but seeking job [15]
☐ Not employed,
not seeking [16]
☐ Other [90]
3. What is your level of prior education?
☐ Less than high school
graduation [11]
☐ GED [12]
☐ High school
graduate [13]
☐ Some post high
school [14]
☐ Certificate (less
than 2 years) [15]
☐ Associate
degree [16]
☐ Bachelor's degree
or above [17]
4. What is your family status?
☐ Single parent
with dependents [11]
☐ A couple with
dependents [12]
☐ Without children or
dependents [13]
☐ Other [90]
Staff Notes (staff use only)
South Puget Sound Community College does not discriminate on the basis of color, race, national origin, sex, disability, sexual orientation or age in its programs and activities. Students
who need disability accommodations should contact Access Services in Bldg. 22, email dss@spscc.edu or call 360-596-5306.
Date Received
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Add-drop-form Add Drop Withdraw Registration Form (South Puget Sound Community College)

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Completed 25 July 2020

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