Change of Schedule Form

Change of Schedule Form

100 College Drive . Kankakee, IL 60901- 6505
Date

Month Day Year
Date
Change for which term

Fall 20 Spring 20 Summer 20
Name

First Name Middle Name Last Name
Student ID#
Check one

Credit Division Continuing Education and Career Services Adult Education High school credit
Reason for Withdrawal (check only one)

BT – Class time CP – Change of program DS – Lack of disability services EC – Employment conflict FI – Financial problems FP – Family problems HP – Health problems IC – Insufficient career help IW – Institutional withdrawal JP – Could not get help to find job LI – Lack of interest MO – Moving TC – Too many classes TP – Travel problems UC – Unavailable child care UPC – Underprepared for class WA – Called to active duty
Other
Withdrawal request
Students are responsible for providing correct course and section numbers on the schedule below. Please check for accuracy: Provide Course Prefix,Course number, Section number,Course title, Sem hrs.
ENGL 1613 030 ENGLISH 6 sem hrs.
Add request Students are responsible for providing correct course and section numbers on the schedule below. Please check for accuracy: Provide Course Prefix, Curse number, Section number, Course title, Sem hrs
ENGL 1613 030 ENGLISH 6 sem hrs.
I certify the above information has been verified as correct, and I will notify the Office of Admissions and Registration of
further changes in writing.
I acknowledge the following: (1) I am modifying my course schedule which may have a financial impact on my balance due
to KCC. (2) I have discussed the financial impact with the Accounting and Financial Aid offices. (3) If I withdraw after the refund period, I will
be obligated to fully pay for the course(s) – even if I never attended any class sessions. (4) I am responsible for all legal fees and collection
costs KCC may incur. My signature confirms I have read and understand these terms and conditions.
Student signature
Advisor signature
For Office Use Only
_____ SH enrolled in after change
______ Total withdrawal (“0” SH above) and Title IV aid recipient, provide the Office of Financial Aid with copy of change of schedule and Initials bill prior to processing the change of schedule and enter the last date attended. _____ Month _____ Day ______ Year of last attendance
Should be Empty: