DOB
/
/
Student ID Number:
Name:
(First(Last)
(MI)
Today’ Date:
/ /
_____ hours
_____ hours
Retention:
________________________________
Date:
Financial Aid:
_____________________________
Date:
Enrollment Services:
_______________________
Date:
Reason:
Student’s Signature (required)
Year
This document contains both information and form fields. To read information, use the Down Arrow from a form field.
LOUISIANA DELTA COMMUNITY COLLEGE
Division of Student Affairs· Department of Enrollment Services
Add/Drop/Resignation Form
CIRCLE
Fall Spring Summer
Resign from ALL Classes
COURSE LOAD
I was enrolled in .
These changes give me .
Function
(Circle One)
Course
Abbreviation
Course
Number
CRN
Sem.
Hrs.
Approval Signature
Course Instructor:
Late Add Only
Approval Signature: Dept. Head/
Dean/Campus Dir.
(if applicable)
Approval to Add/Drop after
published deadline:
Students Dean/Campus Dir.
add drop
add
drop
add
drop
add
drop
add
drop
Student’s Instructions
This form should ONLY be used
if student is unable to add/drop
using LoLA (banner).
Use ball-point pen
I certify that I am requesting all changes above and that all
signatures are authentic.
***Student Needs Signatures from:
LOUISIANA DELTA COMMUNITY COLLEGE
Division of Student Affairs· Department of Enrollment Services
Add/Drop/Resignation Form
DOB
/
/
CIRCLE
Fall Spring Summer Year
Resign from ALL Classes
COURSE LOAD
I was enrolled in _____ hours.
These changes give me _____ hours.
Sem.
Hrs.
Course
Number
Course
Abbreviation
add
add
drop
add
add
drop
drop
drop
CRN
add
drop
Function
(Circle One)
Approval Signature
Course Instructor:
Late Add Only
Approval to Add/Drop after
published deadline:
Students Dean/Campus Dir.
Approval Signature: Dept. Head/
Dean/Campus Dir.
(if applicable)
Student’s Instructions
This form should ONLY be used
if student is unable to add/drop
using LoLA (banner).
Use ball-point pen
***Student Needs Signatures from:
Retention:________________________________Date:
Financial Aid:_____________________________ Date:
Enrollment Services:_______________________ Date:
I certify that I am requesting all changes above and that all
signatures are authentic.
Student’s Signature (required)
Reason:
Phone Number:
Today’ Date:
/ /
Name:
(First(Last)
(MI)
Student ID Number:
Phone Number: