Rev. 03/24/20
WEBSITE COPY
TERM/YEAR: FALL ______ SPRING ______ SUMMER ______ DATE _____________________
PROGRAM OF STUDY ___________________________________________ ADVISOR ____________________________________________________
PRINT NAME __________________________________________________________________________________ ID NUMBER ___________________
LAST FIRST MIDDLE INITIAL
CHECK BOX IF APPLICABLE: FINANCIAL AID VETERANS’ BENEFITS
TUITION PAYMENT PLAN OTHER (specify) ____________________
SECTION
(EX. 0001)
REASON
SECTION
(EX. 0001)
DEAN/INSTRUCTOR SIGNATURE
DATE ________________________
DATE ________________________
DROP/ADD/WITHDRAWAL FORM
If you receive any financial assistance, verify the impact of
adjusting your schedule prior to submitting this form.
ADVISOR SIGNATURE ______________________________________________________________________
STUDENT SIGNATURE ______________________________________________________________________
Unless sent from an official Rockingham Community College email account, this form must have a handwritten signature.
RECORDS OFFICE _________________ DATE ____________
BUSINESS OFFICE _________________ DATE ____________
ORG
DROP
ADD
TOTAL
CR TUITION ACT. FEE
REFUND:
DUE REFUND: TUITION _____________________
ACTIVITY FEE (601) _____________________
CREDENTIAL FEE _____________________
CAPS FEE _____________________
TECHNOLOGY FEE _____________________
TOTAL REFUND: _____________________
75%
10
0%
Advisor signature is not required but it is recommended students consult with their advisor prior to adjusting their schedule.
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