Rev. 2009
Office of the Registrar
P.O. Box 749
Barrow, AK 99723
Phone: 907.852.1788 or 1763
Fax: 907.852.1784
PLEASE PRINT CAREFULLY – Complete all information requested below
Semester (Check one): Spring Summer Fall Year 20_____
Last Name First Name Middle
SS# (new students only) or student ID
Mailing Address
City
State
Zip Code
Date of Birth
E
-
mail Address
Work Phone
DROP OR WITHDRAW FROM A COURSE
To drop/withdraw from a semester-long course, submit this form to the Registrar’s Office before the last day of student-initiated withdrawals.
To drop/withdraw from a short-term course, submit this form to the Registrar’s Office before the course is 60% complete.
Dept Course # Sec # Course Title Time & Place Credit Instructor
Reason for Drop/Withdrawal Will this drop/withdrawal change affect your financial aid?
Course Content
Employment
Health Yes
Instructor
Personal
Other No
Note: Your financial aid may be affected if you complete the semester with fewer credits than are required by your aid program.
ADD A COURSE
To add a semester-long course, submit this form to the Registrar’s Office before the last day to add semester-long classes.
To add a short-term course, submit this form to the Registrar’s Office before first (1) Friday after the first day of instruction for the class.
Dept Course # Sec # Course Title Time & Place Credit Audit Instructor
CHANGE CREDIT/AUDIT
You must be currently enrolled in the class for credit/audit to use this form to change to credit/audit.
Credit to Audit – Submit this form to the Registrar’s Office before the last day for faculty-initiated withdrawals.
Audit to Credit – Submit this form to the Registrar’s Office before the last day to add semester-long classes.
Dept Course # Sec # Course Title Time & Place Instructor
Credit to Audit
Audit to Credit
Credit to Audit
Audit to Credit
Credit to Audit
Audit to Credit
BILL TO: (Please fill out this part if the billing is not going to you.)
Financial Aid Employer-Funded Grant-Funded Other
Contact Person: Address or Phone #:
Student Signature (Required) Date Business Office Signature Date
Advisor Signature (Instructor) Date Registration Office Signature Date
Print Form
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