Fillable COURSE ADD/DROP REQUEST FORM (Hawaii Pacific University)

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COURSE ADD/DROP REQUEST FORM (Hawaii Pacific University)

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COURSE ADD/DROP REQUEST FORM
1. Review the Academic Calendar (www.hpu.edu/academiccalendar) for all important dates and deadlines.
2. A complete withdrawal from all courses requires a different form.
STUDENT INFORMATION: ( Complete all information )
Student ID: @________________________________________
Name: _____________________________________________
Last/Family Given/First Middle
Mailing Address:______________________________________
Number/Street
___________________________________________________
City/Town Country/State Zip/Postal Code
Term/Year: _________________________
College or Major: _____________________
Check one: Undergraduate
Graduate
Please answer the following questions:
Telephone: __________________________________________
HPU Email: ___________________________@my.hpu.edu
Are you a financial aid recipient? Yes* No
Are you an international student? Yes* No
*If yes, applicable signature(s) required below.
DROP: (
List courses you are dropping
)
CRN Course Alpha Credit Hours Part of Term/
Course Ref. No. and No. Session
_____________ _______________________ ______________ _________
_____________ _______________________ ______________ _________
_____________ _______________________ ______________ _________
CRN Course Alpha Credit Hours Part of Term/
Course Ref. No. and No. Session
_____________ _______________________ ______________ _________
_____________ _______________________
______________ _________
_____________ _______________________ ______________ _________
ADD: (List courses you are adding )
CRN Course Alpha Credit Hours Part of Term/
Course Ref. No. and No. Session
_____________ _______________________ ______________ _________
_____________ _______________________ ______________ _________
_____________ _______________________ ______________ _________
CRN Course Alpha Credit Hours Part of Term/
Course Ref. No. and No. Session
_____________ _______________________ ______________ _________
_____________ ____
___________________ ______________ _________
_____________ _______________________ ______________ _________
Number of credits hours before above change: ________________ After this change: _________________
Dean’s Approval: ( Required for exceptions to deadlines )
Comments:_______________________________________________________________
Dean’s Signature: ____________________ ______________________ Date: ________
PRINT NAME SIGNATURE
DEAN’S USE ONLY:
Drop with “W” Grade:
Yes No
My signature below indicates I have read and accept the policies and deadlines published by Hawai‘i Pacific University. Digital signatures not accepted.
Student’s Signature ______________________________________________________________ Date: ______________
Academic Advisor ___________________________________ ___________________________ Date: ______________
PRINT NAME SIGNATURE
Business Office _____________________________________ ___________________________ Date: ______________
PRINT NAME SIGNATURE
*Financial Aid _______________________________________ ___________________________ Date: ______________
PRINT NAME SIGNATURE
*International Office __________________________________ ___________________________ Date: ______________
PRINT NAME SIGNATURE
Revised 01/13/2020
Office Use Only:
SFAREGS____________ Date: _______
Charge fee___________ Date: _______
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COURSE ADDDROP REQUEST FORM (Hawaii Pacific University)

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Completed 23 July 2020

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