KM 08/2017
INSTRUCTOR PERMISSION FORM FOR LATE REGISTRATION
Registration after the first day of class will require written permission from the instructor. Full payment is due immediately.
Name: Student ID Number:
_____________________________________________________________________________________________________________
Last First Middle
INDICATE TERM OF REGISTRATION: FALL ________________ SPRING_______________ SUMMER_______________
A (Add)
If Audit
Enter
‘Y’
Course
Prefix
#
CRN
Semester
Hours
Title
Days
Time
Advisor’s
Initials
I understand that I may have additional fees applied to my account due to 3
rd
or 4
th
course attempt.
By registering for courses, I understand and agree that I am registering for courses and am responsible for the payment of all tuition and fees by the established due dates on
academic calendar, unless I drop the courses during the refund period. If my account becomes delinquent, I will be responsible for paying the College all past due amounts/service
charges and any associated collection agency fees up to a maximum of 30% of the account balance, reasonable attorneys’ fees, cost and expenses incurred by the College in its
collection efforts. I agree to give CFK and its agent’s permission to contact me on my home or mobile phone, email address, and mailing address. By signing below, I am entering
into a legal and binding contract with The College of the Florida Keys and I hereby acknowledge that I have read and understand the Terms and Conditions of this registration
agreement and Student Financial Responsibilities policy located in Student Catalog.
Student’s Signature
Date
Instructor’s Signature
*Instructor must submit this form electronically to advising.services@fkcc.edu
Date
Advisor’s Signature
Date
COMMENTS FOR OFFICE USE ONLY:
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