Received: By:
Semester: Year:
Petition to Add/Drop After Deadline
Name: Student ID #:
Last First M.I
Address:
Street # City State Zip Email Address
Evening Phone #:
5-Digit
Call No.
Dept. &
Course No.
Sect. Units Instructor Signature Date
5-Digit
Call No.
Dept. &
Course No.
Sect. Units Date
Department Chair Signature: Date Department Chair Signature: Date
College Dean (required after 4th week of the semester) Date
Office Use Only: Office Use Only:
Date: By: Date: By:
Use a separate form for each academic department.
*** Return to the College of Continuing Education in Napa Hall ***
Instructor Signature
Add This Course:
Drop this course
The accuracy of your registration is your responsibility. You must obtain necessary signatures and deliver the signed form to the proper offices.
Write or type your reasons for requesting a late add/drop on a separate page, and attach with documentation to the signed petition.
College Dean (required after 4th week of the semester) Date