EMAIL - Registration Add/Drop/Withdrawal Form
Student’s Last Name
First
Middle Initial
Student ID#
Current Phone Number
Date
Fall Spring Summer
Academic Year 2020/2021
If you are currently attending another college, please specify:
Dept
Number Section Term Hr Days of Week
Time Start Time Stop Date Start Date End
1
2
3
4
5
6
EX
ENG
121S
001FS 2020SS
3
M and W
12:00
1:45
01/19/2021 05/15/2021
To DROP Class(es)
Dept.
Number
Section
Term
Hr
Why are you dropping this course(s)?
Please mark all that apply.
Schedule/section change
Registered for too many hours
Conflict with work
Dissatisfaction with instructor
Change of major/interest
Childcare/family conflict
Demands of the class were too great
Transportation problems
Financial problems
Other_________________________
Advisor/Instructor Notes:
1
2
3
4
5
Advisor’s Signature
Date
3
(Advising recommended for all students: advisor signature required for students on academic probation)
I understand that by registering for the above classes I am responsible to pay for these classes unless I officially drop them
during the 100% refund period as published in the College catalog.
Student’s Signature
Date
PIQUA 937-778-8600
GREENVILLE 937-548-5546
EATON 937-683-8169
TROY 937-778-1811
REGISTRATION ---- FOR OFFICE USE ONLY
By
Date
Received
By
Email
IMPORTANT NOTES
If you are a new student, complete an Application for
Admission before attempting to register.
If you are on Academic Probation, you must secure an advisor’s
signature on this form in order to register.
If you are a CCP student, please use the CCP registration form.
For an advising appointment, call 937-778-8600.
Transient students must attach proof of pre-requisites to the
registration form.
Any registration submitted after payment due date must include
payment. Checks should be made payable to Edison State
Community College.
HOW TO REGISTER
This form is designed to be submitted by email.
Return this completed form to registration@edisonohio.edu.
If you are a current Edison State student, you must use your
edisonohio.edu email address.
You may also register in the following manners:
Online:
https://selfservice.edisonohio.edu:8173/Student/Account/Login
By Fax to 937-778-4692
By Postal Mail:
EdisonState Community College
Attn: Student Services
1973 Edison Dr.
Piqua, OH 45356
Note: Compared to Online Registering, registrations received
by email, fax, or postal mail may be delayed in processing.
No Registration is accepted by phone.
click to sign
signature
click to edit
click to sign
signature
click to edit
Rev. 03/12/2020
Registration Procedures (Register for classes in Web Advisor, or at any of the campuses)
General Information
Select classes with help of an
advisor or faculty member.
Obtain the advisor’s signature if
you are receiving or expect to
receive financial aid or
veteran’s benefits.
Current students can register for
most courses through MyESCC:
https://
selfservice.edisonohio.edu:8173/
Student/Courses
If MyESCC registration is not
available, present your
s
chedule request to Student
Services on any campus or
email to
registration@edisonohio.edu
Print clearly the department,
number, section, and term code
on the reverse of this form.
(These numbers are available in
MyESCC.)
O
nline-learning readiness must
be demonstrated prior to taking
online courses.
Registration is complete when
payment or arrangements for
payment have been made.
To drop or withdraw from a
class, log in to MyESCC. Select
the course you wish to drop or
withdraw from and submit. You
may also withdraw from classes
at any campus or by sending
this registration form as
instructed on the front page.
First Time Students
Before you register for classes
you must complete an
application for admission and
satisfy other admissions
requirements. Call 937-778-
8600 for information or inquire
in Student Affairs, Room 160.
Senior Citizens
Senior citizens who plan to
request tuition waiver may
register for to “audit” during
the week before the term
starts.
SOCHE Cross-Registration
SOCHE Cross-Registration
registrations must be
approved by the Registrar.
Registration for guest
students will be during the
week before the term starts.
Special Dates Reminder
Look in the online Academic Catalog
for these dates:
Registration opens
Payment due for unpaid
registrations
Last date to register
Last date for refund
Last date to officially withdraw
Starting dates for irregularly
scheduled classes
Deferred payment dates