NASSAU COMMUNITY COLLEGE KE>/EDROP/ADD FORM
__________________________________________________
(Print) Last Name First Name
TERM: FALL WINTER SPRING SUMMER YEAR 20____________
Students who drop classes after the start of any term will incur part or all of their tuition and fees liability according to the published fee schedule for that term.
INSTRUCTIONS: 1) Complete all items above. 2) If withdrawing from Nine (9) credits or more obtain the signature of a Counselor in the CERC Office located in
Nassau Hall (Room 13). 3) Instructor’s email confirmation required for each course after the refund period. 4) Sign the form acknowledging your
responsibility as it relates to tuition and financial aid.
LIST COURSE(S) TO DROP LIST COURSES TO ADD
CERC Counselor Signature __________________________________________________ Date _____________________________________________________
Student’s Signature _______________________________________________________* Date _____________________________________________________
* Students are responsible for their registrations and withdrawals. Once officially enrolled, students accept financial responsibility for payment
of all charges in connection to their registration. Students should be aware that withdrawal from one or more courses may affect some, or
possibly all, financial aid awards. Never attending a course(s) without notifying the Office of the Registrar in writing is not an acceptable
means of withdrawal and will result in a tuition liability.
FORM REVISED JAN 31, 2012
CRN (Course
Registration Number)
SUBJECT
SECTION
CREDITS
INSTRUCTOR’S
SIGNATURE
CRN (Course
Registration Number)
SUBJECT
CREDITS
N
0
0
TOTAL CREDITS DROPPED
TOTAL CREDITS ADDED
FOR REGISTRAR’S USE ONLY:
Administrative change processed by _________________ __________________
Initials Date
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signature
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