Fillable Dual Enroll Ecco Add Drop Regis Add Drop (Eastern Florida State College)

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Dual Enroll Ecco Add Drop Regis Add Drop (Eastern Florida State College)

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U.S.A. forms for Eastern Florida State College

BROWSE EASTERN FLORIDA STATE COLLEGE FORMS

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Dual Enrollment
Early College Credit Option (ECCO)
Add/Drop Form
Student: Complete this section legibly "in ink" before seeing advisor.
Student Identification Number
Term:_______________________ Today’s
Date:__________________
This is a new address and/or phone number. Please update my records.
Name:_____________________________________________________________________________
Last First Middle
Address: ____________________________________________________________________________
City: ________________________________________________ State:_______ Zip: _____________
Telephone: _____________________________
REGISTRATION REASON:
DEGREE CODE MAJOR CODE INTENT
* INSTRUCTOR/DEPARTMENT CHAIR APPROVAL REQUIRED FOR EXCEPTIONS:
My signature represents approval of the following exceptions for this course: (Please check reason, sign and date next to class.)
1. Pre-requisite waived 3. Course overload on closed classes 5. Late Add
2. Co- requisite waived 4. Other: Campus Associate Provost 6. Course Reinstatement
Eastern Florida State College is an equal opportunity/equal access institution.
SC-003A R110614
Student
Signature:____________________________________
Parent
Signature:____________________________________
You must read and consent to the information on the back of this form
prior to registration.
H D
(See EFSC Programs and Major Codes sheet)
INPUT BY:
I agree to pay for tuition, fees and instructional materials associated with
courses registered through the ECCO program. I recognize that credits
earned through this option will NOT count toward high school graduation.
Student must provide their most recent high school transcript indicating unweighted state GPA of 3.0 or higher. A new transcript
is required each term of enrollment. College ready reading and writing scores are required for participation in ECCO.
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REGISTRATION and
FINANCIAL RESPONSIBILITY AGREEMENT
Thank you for choosing Eastern Florida State College. In addition to all Eastern Florida State College (EFSC)
academic standards and policies, I hereby agree to comply with the terms and conditions specified in this
Registration and Financial Responsibility Agreement in order to enroll for courses at EFSC. I also agree to abide by
rules and regulations described in the EFSC Catalog and EFSC Student Handbook.
I acknowledge that any activity I conduct through EFSC indicates my agreement to the specified terms and
conditions, including my agreement to be financially responsible to EFSC for payment of all tuition, fees and related
costs of enrollment for classes in which I am registered whether or not I attend the class.
I understand that course(s) must be dropped before the end of the drop period in order to be eligible for a full
refund. It is my responsibility to drop my classes as the college will not automatically drop them for me.
I acknowledge that if I withdraw from a course(s) after the end of the drop period, or if I am administratively
withdrawn for non-attendance or other reasons, I will be responsible for repaying any applicable Bright Futures
Scholarship funds, Federal Title IV financial aid funds, or any other amount due as a result of the withdrawal. Any
reduction in financial aid based on nonattendance will result in a balance due to EFSC.
I understand past due student account balance will result in a financial hold, which prevents future registrations as
well as other services being offered in accordance with college policy. I understand and agree that EFSC will
withhold transcripts, diplomas, and other services until all outstanding balances have been satisfied in full.
I acknowledge that all outstanding obligations (along with appropriate personal information including social security
number) may be referred to an outside collection agency and credit reporting bureaus.
I understand that I am responsible to reimburse EFSC the fees of any collection agency, which may be based on a
percentage not to exceed 33% of the debt, including attorney fees and court costs.
In addition, I agree to allow EFSC and its agents to contact me at any cell phone number that I provide now or use
in the future, using automated telephone dialing systems, artificial or pre-recorded voice or text messages, or
personal calls regarding my obligation to repay my debts to the EFSC.
I also authorize EFSC or its agents to contact me via my easternflorida.edu address or an email address that I
provide to EFSC. I understand that others may be able to review my messages and/or emails related to my debts
sent to or from EFSC including their contents, which may include information about my debt and its status.
I understand that EFSC uses Titan E-mail, a free student email system, as the official means of communication for
registered students. Financial Services utilizes this system for notifications regarding student accounts. Students
should maintain and check their EFSC e-mail accounts regularly.
I understand this agreement shall be construed in accordance with Florida law, and any lawsuit to collect unpaid
fees may be brought in the appropriate court sitting in Brevard County, Florida, regardless of my domicile at the
time of bringing such action.
I
unde
rstand by signing thi
s
fo
r
m,
I a
m
ag
r
eei
ng to all terms and conditions set forth herein above and agree to the
incorporation of any other related documents. I enter into this Registration and Responsibility Agreement with full
knowledge of its legal implications and without coercion and/or promises made to me by the college. I also agree
and acknowledge that prior to agreeing to this Agreement, I have the right and option to discuss the terms and
conditions herein with a private attorney at my sole expense.
____________________________________________ B_____________________________________
Student Signature Date
Student ID Number
____________________________________________ Term:_________________________________
SC-003A R110614
Parent Signature
Date
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Dual Enroll Ecco Add Drop Regis Add Drop (Eastern Florida State College)

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Completed 23 July 2020

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