Fill - Free fillable Enrollment Information Admissions & Records Add / Drop (College of the Siskiyous) PDF form

Admissions & Records

College of the Siskiyous, 800 College Ave., Weed, CA 96094

Phone: (530) 938-5500 - Fax: (530) 938-5367 – Email: registration@siskiyous.edu

Add / Drop Form

Semester:  Fall  Winter  Spring  Summer Year:

Last Name: First Name: MI:

Date of Birth: Student ID#: S00 or SSN:

Enrollment Information

I verify that I am responsible for the course choices listed below and that I have read the prerequisites and advisories for

these courses in the college catalog. The information I have provided is true and correct.

Student Signature: Date:

* If you complete this form and send it through your COS email account, it will count as your signature.

CRN

Add Course No.

Units

Authorization Code

CRN

Drop Course No.

Units

Complete Withdraw

 I verify that I am completely withdrawing from all my courses for the above term at College of the Siskiyous.

I am withdrawing due to:  Financial  Military  Medical  Personal  Other

Explain (Optional):

 I plan to re-enroll at COS in the next semester  I do not plan to ever attend COS again at this time.

Office Use Only

Entered by: Date:

For K-12 Students

Student’s age and grade level on first day of COS course:

Age: Grade Level:

Current School:

City: State: Zip Code:

Student Signature: Date:

I swear under penalty of perjury that the above information is true and correct.

Parent Signature: Date:

I understand that some course topics may not be appropriate for minors. These courses and grades will be

recorded on the student’s permanent college transcript.

School Official Signature: Date:

School Official Name (please print):

Phone: Email:

I certify that this student will benefit from college level work and I recommend him/her for enrollment in the course(s) listed

above. (Education Code 76001-02) For Summer Session: I certify that I have not recommended for enrollment in

nonexempt courses at College of the Siskiyous more than five percent of the total number of pupils who completed the

above named student’s grade level. (Education Code 48800)

Students age 15 and under (as of the first day of the COS semester) need Counselor approval.

COS Counseling Signature: Date:

 Approved  Disapproved

Download
Save PDF to desktop

Email
Email completed PDF

Send for Signing
Email for others to sign

Print
Print document

NAME

Enrollment Information Admissions & Records Add Drop (College of the Siskiyous)

View Audit Log
Print With Audit Log
Duplicate Document

Fill Online, Printable, Fillable, Blank Enrollment Information Admissions & Records Add / Drop (College of the Siskiyous) Form

Related forms

Fillable Enrollment Information Admissions & Records Add / Drop (College of the Siskiyous)

Fill Online, Printable, Fillable, Blank Enrollment Information Admissions & Records Add / Drop (College of the Siskiyous) Form

Related forms

First 20 documents completely FREE!