Fillable Fall Spring Summer Telephone # 31 College Drive (NHTI – Concord's Community College)

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Fall Spring Summer Telephone # 31 College Drive (NHTI – Concord's Community College)

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NHTI – Concord’s Community College | www.NHTI.edu
Part of the Community College System of New Hampshire
ID #:
Reason for Withdrawal
(Check One – The major reason for withdrawing)
Family/Marriage Responsibilities
Transfer to another College
Time and/or Scheduling
Concerns Travel Concerns
Employment Opportunity
Name:
Major:
Telephone #
:
Mailing Address:
Academic Concerns
Accepted Elsewhere
Military
Childcare Issues
CareerGoal Change
Relocation
Financial Difficulty
Health Problems
Housing Issues
Work Conflict
Personal
Other
All courses will be dropped with a “W” grade if this form is received in the Registrar’s Office prior
to the official “Last Day to Drop/Withdraw with a “W” grade”. www.nhti.edu/academics/acdmccalendar.html)
Upon a drop or withdrawal, I understand that I will be responsible for all charges as noted in the student catalog and
handbook. I further understand that if I do not make payment in full, my account may be reported to the credit bureau
and/or turned over to an outside collection agency. I also agree to pay for the fees of any collection agency, which may be
based on a percentage of the debt up to a maximum of 35%, and all additional costs and expenses, including any
protested check fees, court filing costs and reasonable attorney’s fees, which will add significant costs to my account
balance.
Student’s Signature
“FOR REGISTRAR’S OFFICE USE ONLY”
Date Received: Processed By:
Rev 08/06/2021
College Withdrawal Form
Return to: Registrar’s Office
31 College Drive
Concord, NH 03301-7412
Phone: 603-230-4012 Fax: 603-230-9314
nhtiregistrar@ccsnh.edu
Year:
Fall
Spring
Summer
Email Address:
Date:
Comments:
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Fall Spring Summer Telephone 31 College Drive (NHTI Concord's Community College)

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Completed 13 August 2021

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