Asnuntuck ADD/DROP FORM
Community College
Regi strar’s Office, 170 El m Street, Enfi eld, CT 06082
Email Completed Form to: AS-Registrar@Asnuntuck.edu
Semester Add/Drop: FALL 20 ____ SPRING 20 ____ SUMMER 20 _____ WINTER 20____
Student ID # ___
__________________
La s t Na me: __________________________________ First Na me: ___________________________ Middle /Ma iden Name : __________ __ _ __ __ _ _
Ema il Addres s : _____________________________ __ _ __ __ _ ________________________________ Prima ry Phone: _________________________
If any of your contact information has changed, please complete the following:
Address _______________________________________________________________________________________
Number, Street, City, State, Zip
Are you receiving VA Benefits? Y
es No Are you receiving Financial Aid? Yes No
Please follow the specific directions as they pertain to added and/or dropped classes as stated in the Add/Drop Policy.
ADD
DROP
Last Date Attended Each Class
Advisor’s Signature___________________________________________________ Date _______________________
REFUND POLICY: Application, Student Activity, and College Service Fees are NON-REFUNDABLE. For more detailed information, please visit
www.asnuntuck.edu/tuition-fees or you may obtain a Student refund Policy brochure at the Cashier’s Office. Fall/Spring Semesters: A refund of
100% of Tuition and Lab Fees will be granted for notices of withdrawal received prior to the first day of the semester. For full-term classes, a
refund of 50% of Tuition and Lab Fees will be granted for notices of withdrawal received from first day of the semester through the fourteenth
calendar day of the semester. No refunds will be granted after the fourteenth calendar day of the semester. Different deadlines may apply for
accelerated classes. Summer/Winter Semesters: A refund of 100% of Credit Extension and Lab Fees will be granted for notices of withdrawal
received on or before the last business day before the sta rt of the term. No refunds will be granted as of the first day of the class.
To the best of my knowledge, the information on this form is complete and accurate. I assume responsibility for knowing and
following course prerequisites, co-requisites, program requirements, and payment obligations.
Student Si gnature ________________________________________________ Date _______________
Authorized: __Yes __No If yes, Refund Category: ____Total _____Full Tuition ____ Half Tuition
Notice of Non-discr imination: Asnuntuck Community College does not discriminate on the basis of race, color, religious creed, age, sex, national origin, marital status,
ancestry, present or past history of mental disorder, learning disability or physical disability, sexual orientation, gender identity and expression or genetic information
in its programs and activities. In addition, the College does not discriminate in employment on the basis of veteran status or criminal record. The following individuals
have been designated to handle inquiries regarding the non-discrimination policies: Yhara Zelinka, Title IX Coordinator, yzelinka@asnuntuck.edu (860) 253-3092 and
Deborah Kosior, 504/ADA Coordinator, AS-DisabilityServices@asnuntuck.edu (860) 253-3005, Asnuntuck Community College, 170 Elm Street, Enfield, CT 06082.
Políticas Antidiscriminatorias: Asnuntuck Community College no discrimina por razones de raza, color, creencias religiosas, edad, género, nacionalidad, estado civil,
ascendencia, historia presente o pasada de discapacidad mental o física, problemas de aprendizaje, orientación sexual, Identidad y expresión de género, o
información genética, en sus programas o actividades. Adicionalmente Asnuntuck no discrimina individuos por razones pertinentes a la categoría de veteranos o
historia criminal. Las siguientes personas han sido designadas para resolver cualquier inquietud pertinente a las políticas antidiscriminatorias: Yhara Zelinka, Title IX
Coordinator, yzelinka@asnuntuck.edu (860) 253-3092 and Deborah Kosior, 504/ADA Coordinator, dkosior@asnuntuck.edu (860) 253-3005, Asnuntuck Community
College. UPDATED March 2020
