MCC-421 Equal Opportunity College/Affirmative Action Employer Rev. 9/17
Drop/Add for Early College & Career and College Promise
Student must initiate this form and obtain the required signatures. Requests will not be processed without the required
signatures. All fields are required.
Year ________ Semester
Dept. & Course # Section Course Title Credit Hours
I acknowledge that I may face academic and/or financial penalties from my high school for dropping the above listed courses. I have
consulted with my high school regarding the decision to drop these courses.
Student Signature Date
HIGH SCHOOL USE ONLY
Please initial, sign, and date. Return directly to Amanda Rhea at firstname.lastname@example.org.
__________ This student is dropping the above course(s) with my permission and is not responsible for reimbursing the sponsor for costs
associated with enrollment.
__________ This student is dropping the above course(s) and is fully responsible for reimbursing the sponsor for the costs associated with
Principal/Designee Signature Date
Please return to your appropriate Mitchell liaison:
Career & College Promise l Amanda Rhea l email@example.com
Agriculture & Science Early College | Allison Snyder | firstname.lastname@example.org
Collaborative College for Technology & Leadership l Sharon Ellis l email@example.com
Crossroads Arts & Science Early College l Mamie Houston l firstname.lastname@example.org