Fillable COURSE SCHEDULE ADJUSTMENT FORM (State University of New York at Plattsburgh)

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COURSE SCHEDULE ADJUSTMENT FORM (State University of New York at Plattsburgh)

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COURSE SCHEDULE ADJUSTMENT FORM
Students
: Print or download this form, saving with a new name. Complete the top section. Bring or email the form to the first approver as
indicated by the course adjustment requested.
Student’s Name: _________________________________ ID: _____________________________________
Advisor Name: __________________________________
Check One: □ Late Course Add □ Course Withdrawal □ Late Course Withdrawal
Date of last attendance for withdrawal requests _______
I will carry _______ credit hours this semester after the following course schedule adjustment.
International Students: Withdrawing from a course could impact your full-time enrollment status and/or compliance with online course
limitations based on U.S. immigration rules. Please consult with the Global Education Office (geo@plattsburgh.edu) before submitting form.
Financial Aid: Withdrawing from this course could impact your financial aid in the current and/or future semesters. Due to complex
regulations, you should consult with the Financial Aid Office (FAO) before you withdraw. Initial one of the following:
____ I opt not to, or do not need to, consult with the FAO ____ I have already consulted with the FAO
COURSE INFORMATION:
Course Reference Number (CRN): ___________ Course Subject, Number, Section:__________ Semester/Year: _____________
Instructor’s Name: __________________________________________________________________
Adjustment and Approvals
LATE COURSE ADD
: Beginning the second Monday of each semester, a $20 late course add fee will be applied to the student’s bill
unless extenuating circumstances apply. The following approvals are required:
Approver
Signature or indicate approval in email
Date
Forward to:
Instructor
Chairperson
Chairperson of Course
Dean
Dean of Course
Registrar
COURSE WITHDRAWAL: Courses may be dropped online without tuition during the first seven days of the semester. For fall and
spring full-semester courses, commencing on the eighth calendar day of the semester and ending at midnight on the Friday of the tenth
week (or mid-point for courses offered less than a full semester) a student who submits a completed Course Schedule Adjustment Form may
withdraw from any class after consultation with the course instructor and advisor. Refer to winter and summer registration guides for
withdrawal dates. A $20 course withdrawal fee applies. A W (withdrawal) will appear on the student’s transcript.
Approver
Signature or indicate approval in email
Date
Forward to:
Instructor
Academic Advisor
Academic Advisor
Registrar
*Academic Advisor signature required for Fall/Spring only. In Winter/Summer, Instructor emails Registrar’s Office directly
LATE COURSE WITHDRAWAL: Withdrawal is generally not allowed after the published withdrawal date. Appeal based on written
documentation of extenuating circumstances is possible. Failing grades are not justification for late course withdrawal. If approved a W
(withdrawal) will appear on the student’s transcript. Attach documentation of extenuating circumstances and obtain the dean’s signature.
The student should continue attending the course until a decision is made.
Approver
Signature or indicate approval in email
Date
Forward to:
Dean
Registrar
Course schedule adjustments will be reflected on class rosters and the student record.
Email the Registrar’s Office at registrar@plattsburgh.edu.
VPAA 10/2/2020
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COURSE SCHEDULE ADJUSTMENT FORM (State University of New York at Plattsburgh)

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Completed 1 February 2021

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