January 5, 2015, Change_of_Enrollment.doc
Office of the Registrar
Stevens Institute of Technology
Castle Point on Hudson
Hoboken, NJ 07030-5991
FAX 201.216.8050
registrar@stevens.edu
http://www.stevens.edu/registrar
Change of Enrollment
LAST NAME STUDENT IDENTIFICATION NUMBER
FIRST NAME MIDDLE NAME
MAILING ADDRESS
OR SIT BOX
STREET
UNDERGRADUATE
CLASS OF 20 ____
GRADUATE
CITY STATE ZIP CODE
STUDENT SIGNATURE DATE
The signature of the instructor and reason is required for prerequisite waivers, waiving cap, etc.
The signature of the instructor is required for adds after the end of the drop/add period.
Drops after the end of the drop/add period will be recorded as withdrawals (W) on the transcript.
For Graduate Withdrawals: The signatures of the instructor, advisor and the Dean of Graduate Academics are required
after the specified date in the academic calendar.
For Undergraduate Withdrawals: The signatures of the instructor and approval of the Office of Undergraduate Academics
are required after the specified date in the academic calendar.
TERM: FALL WINTER SPRING SUMMER I SUMMER II YEAR TERM YEAR: 20 ____
ADD
SUBJECT
(e.g. MA)
NUMBER
(e.g., 123)
SEC.
(e.g., A)
CRED. INSTRUCTOR’S SIGNATURE DATE REASON FOR OVERRIDE
(INSTRUCTOR USE ONLY)
DROP/WITHDRAW **
SUBJECT NUMBER SEC. CRED. INSTRUCTOR’S SIGNATURE DATE NOTES
(INSTRUCTOR USE ONLY)
APPROVAL SIGNATURES
(Graduate students only) ADVISOR (Drops after the specified date) DATE
OFFICE OF UNDERGRADUATE ACADEMICS/DEAN OF GRADUATE ACADEMICS (Drops after the specified date) DATE
REGISTRAR DATE
ADVISOR/DEAN SPECIAL INSTRUCTIONS:
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