EA
ST TENNESSEE STATE UNIVERSITY
Request to Late Drop
Some, but NOT All Courses
I. PROCEDURES
Note: deadline dates for Late Drops with Dean Permission - see academic calendar: https://www.etsu.edu/ehome/
academicdates/
A. StudentinitiatesprocessbyobtainingrequestformfromtheRecordsOffice,BurginE.DossettHall,room101.
B. Studentpresentscompletedrequest(includinginstructorinput)anddocumentationtothedeanofmajororhis/herdesigneeforreview.
C. Thedeanordesigneemayrequestaconferencewiththestudenttodiscussthisrequest.
D. Deanapprovesordisapprovestherequest,notifiesstudent,and(ifapproving)completestheformwhichisvalidfor
three working days after the date of the dean's approval.
E. Student must pick up the request form and take it to the Records Office.
F. Students should continue attending class and submitting coursework while awaiting the Dean's decision.
II.
STUDENTCOMPLETESTHISSECTION
Student’sName:
Date:
Last First
CumGPA
Classification: Fr. So. Jr. Sr. (circleone)
Email:
Instructor:
Dept. Course Section
Currentlyenrolledinthefollowingothercourses:
Dept. Course Section Dept. Course Section Dept. Course Section
Dept. Course Section Dept. Course Section Dept. Course Section
IfyoureceivefinancialaidorVeteran’sbenefits,listalltypesyoureceive:
Student E Number: _______________________
Total Credits Currently Enrolled:____________
Phone Number:__________________________
Permission is being sought to drop:
Major:__________________________
III. STUDENTSECTIONCONTINUED
EXTENUATINGCIRCUMSTANCESWHICHJUSTIFYDROPREQUEST
(Attachappropriatedocumentationorgivenameofindividualwhocanverifycircumstancesi.e.,physician,employer,etc.Ifyourreasonsareofa
verypersonalnature,youmaywishtostatethosereasonsverballytothedeanordesignee.)
Additionalinformation:Haveyoudiscussedyoursituationwiththecourseinstructor?
When?
Haveyouattendedclassregularly? Haveyoutakenallregularlyscheduledexams?
Haveyoudiscussedyoursituationwithyouracademicadvisor? Whatareyourexam/projectgrades?
Whatisyouradvisor’sname?
Theabovestatementsaretrueandaccuratetothebestofmyknowledge.
Signed:
Student’ssignature Date
IV. FORINSTRUCTOR’SUSE
Hasthestudentdiscussedhis/herperformanceinthecoursewithyou,withaviewtowardcompletionofthecourse?
Hasthestudent’sattendancerecordbeensatisfactory?
Atthispoint,whatisthestudent’sgradeinthecourse?
ADDITIONALCOMMENTS:
Signed:
Instructor’ssignature Date
V. FORDEAN’SUSE
Ifdropisapproved,completebelow.
Approved Disapproved
Signature
Date:
Revised10/14/2019
Grade Assigned W WF (Circle One)
click to sign
signature
click to edit
LATEDROPREQUESTSSHOULDBEDIRECTEDTOTHEFOLLOWING:
UNDECLARED (or Academic Focus Area)
STUDENTS
423-439-5244
University Advisement Center
355 Sherrod Library (3rd Floor)
COLLEGE OF ARTS AND SCIENCES 423-439-5248
COLLEGEOFBUSINESSANDTECHNOLOGY 423-439-6984
Dr. Anthony Pittarese
213 SamWilsonHall
CLEMMER COLLEGE
423-439-7626
JoelTramel
321 WarfPickelHall
COLLEGEOFNURSING
Karen Hirst
230RoyS.NicksHall
COLLEGEOFPUBLICHEALTH
Dr.Robert Pack
104LambHall
COLLEGEOFCLINICALANDREHABILITATIVE
HEALTHSCIENCES
423-439-4243
Megan Roberts
102 Hutcheson Hall
SCHOOLOFGRADUATESTUDIES
(allgraduatelevelstudents)
423-439-4223
Dr.KarinBartoszuk
309BurginDossettHall
SCHOOLOFCONTINUINGSTUDIESAND
ACADEMICOUTREACH
423-439-4221
Dr.Jill LeRoy-Frazier
213 Nell Dossett Hall
Dr. Martha Michieka
355 Sherrod Library (3rd Floor)
423-439-7424
423-439-4523
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