Office of the Registrar
(973) 300-2215 • sussex.edu
One College Hill Road • Newton, NJ 07860
DROP/ADD/WITHDRAWAL FORM
ID #:__________________________________
Date:_________________________________
/
/
PLEASE PRINT
Last Name:
First Name:
SEMESTER: (check one)
M.I.
Address:
YEAR________
City and State:
Zip:
County of Legal Residence:
Home Phone:
Alternate Phone:
FALL________
SPRING________ WINTERIM________
SUMMER I_____ II _____ III ____
E Mail Address:
REASON: _______________________________________________________________________________
ARE YOU A NEW JERSEY STARS STUDENT:
_______________________________________________________________________________
g
g
YES
NO
_______________________________________________________________________________
ADD
DROP/WITHDRAWAL
COURSE
and NUMBER
SECTION
NUMBER
COURSE NAME
CREDITS
COURSE
and NUMBER
SECTION
NUMBER
COURSE NAME
CREDITS
TOTAL CREDITS ADDED
TOTAL CREDITS DROPPED
IF YOU WITHDRAW/DROP AND ARE NOT ENROLLED FOR AT LEAST 12 CREDITS, YOU WILL NOT BE CONSIDERED FULL-TIME.
Student Signature:_________________________________________________________________________________________________
Authorized Signature:______________________________________________________________________________________________
Faculty/Dean Signature (If Needed):__________________________________________________________________________________
REGISTRAR OFFICE USE ONLY
_________ Credit(s) 100% plus fees
(Less Deposit)
_________ Even Exchange of Credits
_________ Credit(s) Added
_________ Credit(s) 50% less fees
_________ Added Lab Fee Only
_________ Credit(s) Canceled Course
Date:_________Initial:_________
_________ Refund Lab Fee Only
White Copy - Registrar
Yellow Copy - Student
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Past Refund Period
Grade: W