Revised: August 22, 2018
DROP, ADD, & WITHDRAWAL FORM
SOUTH ARKANSAS COMMUNITY COLLEGE
Student Services Fax Number 870-864-7137
PLEASE PRINT CLEARLY AND FIRMLY IN INK
RETURN COMPLETED FORM WITH ALL COPIES TO THE REGISTRAR’S OFFICE
NAME: ______________________________________________ STUDENT ID NO: ________________________________
TERM: FALL 20________ SPRING 20________ SUMMER 20________ FIRST________ SECOND________ LONG______
TO
DROP
Course No.
Section
Course Title
TO
ADD
Course No.
Section
Course Title
Time
Instructor’s
Signature
Student’s Signature _______________________________________________ Date ________________________________
white copy Registrar yellow copy Student
Reason for Withdrawal
Personal (state reason) _______________________________________________________________________________
Academic (state reason) ______________________________________________________________________________
_____ Transportation _____ Log in/internet issues _____ Changes in work schedule _____ Death of a family member
_____ Serious illness self or family member (circle one) _____ Moving from area _____ Active Duty (Self/Family)
Hours enrolled before change________________________ Hours enrolled after change ___________________________
Advisors Signature ____________________________ Financial Aid’s Signature ___________________________
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