JOHNSTON COMMUNITY COLLEGE
DROP/ADD FORM
Revised: 6/14
Name _____________________________________________ Date____________________
Last First Middle
Student ID#__________________________________ Date of Birth____________________
Program______________________________ Term: Fall _____ Spring ____ Summer_____
Please be aware that making changes to your class schedule could impact your
financial aid award.
DROP
Course
Prefix
Course
Number
Section
Number
Course Title
Credit
Hours
M
T
W
TH
F
S
ADD
Course
Prefix
Course
Number
Section
Number
Course Title
Credit
Hours
M
T
W
TH
F
S
______________________________ ____________________________________
Student Signature Instructor/Authorized Signature
Last Date of Attendance_______________
REASON FOR WITHDRAWAL Did you accomplish your goal(s) for
(
Please check one.) attending Johnston Community College?
(Please check one.)
_____ 1. Employment
_____ 2. Illness (personal or family
) ___1. Yes, completely
_____ 3. Relocation ___2. No, partially
_____ 4. Course too difficult ___3. No
_____ 5. Course load too heavy
_____ 6. Dissatisfied-Instruction
_____ 7. Transfer to another school
_____ 8. Death in family
_____ 9. Administrative drop
_____10. Personal
************************************************************************
Office Use Only
I acknowledge that I will be receiving
a 75% refund.
_________________________________________________________
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signature
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signature
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