!
!
!
!!1101!Sherman!Drive,!Utica,!NY!13501!
!!!!!!!!!!!!!!!!Phone!(315)!792=5336!
!!!!!!!!!!!!!!!!!!Fax!(315)!792=5698!
!!!!!!!!!!!!!!!!!!!!!!www.mvcc.edu!
!
Student Name ________________________________________ Curriculum ___________________
Last First M.I.
Student M# _________________________________
I am requesting permission to enroll late for this term. Since the deadline has passed, the Office of Records
and Registration will not accept my enrollment without special approval. Please sign below if you agree to my
entering your class at this time.
• I understand that this is a form for obtaining permission to enroll late and does not place me in a program.
• I understand that a full or part-time schedule may not be possible due to class availability.
• I understand that full−time enrollment after the first week of class is not academically advisable.
• I understand that my enrollment in the following course(s) at this date may jeopardize my chances for
success, and I accept full responsibility for this action.
• I agree to pay for all courses to complete my registration.
• I agree to return this completed form to the Office of Records and Registration within one week.
________________________________________________________________________________
Student Signature Date
Student Instructions:
• Obtain the signature of each course instructor permitting late enrollment.
• Obtain additional signatures as needed after the second week of classes.
• Attach a complete Course Selection Form if not already registered for current semester.
• Return this completed form to the Office of Records and Registration within one week.
DISTRIBUTION: Original – Registrar Copy – Student
