Effective Semester

 Spring ____________
 Summer ____ ________
 Fall ____ ________

Add/Drop or Withdrawal Distance Learning - Campus 5

Student ID # __________________________________ Name: ________________________________________________________________________________
Last First M.I.

Email Address: ____________________________________________________ Phone Number ( ) _____________________________________________

Mailing Address: ______________________________________________________________________________________________________________________

(Street/P.O. Box) (City/State) (Zip Code)

Date of Birth: ______/_______/_______ Sex: F M Class: Fr So Jr Sr Gr CVM

College/School ___________________________________________ Major/Concentration __________________________________________________________

List REASON for Add/Drop (attach any supporting evidence) __________________________________________________________________________________

____________________________________________________________________________________________________________________________________
Circle Course Symbol & Number Title CRN
One  (Example: EDE 3223) (Example: Middle Level Education)
ADD
DROP
ADD
DROP
ADD
DROP
ADD
DROP

I have/will read and understand the University’s withdrawal and refund policies. I have/will read and comply with financial aid withdrawal
instructions. STUDENT: By signing and submitting this form to the Division of Academic Outreach and Continuing Education, you are authorizing
Add/Drop or WITHDRAWAL from course(s) listed above through Distance Learning (ONLY) - AOCE. If you are enrolled in Main Campus
course(s), please contact your Dean’s Office to withdraw.

_________________________________________________ _________________________________________________
Student’s Signature Date Student’s Academic Advisor/ Instructor Date

_________________________________________________
Academic Dean’s Signature Date

Spring & Fall Term Only DROP & ADD POLICY Withdrawal Refund Schedule Withdrawal Refund Schedule Withdrawal Refund Schedule
Last day to DROP a course without a “W” grade (5th Class Day) 100% refund Spring/Fall Semesters Ten (10) Week Five (5) Week
DROP after 5th Class Day – “W” grade 0% refund
Summer Term Summer Terms
ADD POLICY - Last day to ADD a class – 6th Class Day
1st Class Day 100%
Summer Term 1st & 2nd 5 week DROP & ADD POLICY 2nd – 10th Class Day 90% 1st Class Day 100% 1st Class Day 100%
Last day to DROP a course without a “W” grade (1st Class Day) 100% refund 11th – 15th Class Day 80% 2nd – 6th Class Day 90% 2nd – 3rd Class Day 90%
DROP after 1st Class Day – “W” grade 0% refund 16th – 20th Class Day 65% 7th – 9th Class Day 80% 4th – 6th Class Day 80%
ADD POLICY - Last day to ADD a class – 2nd Class Day 21st – 25th Class Day 45% 10th – 12th Class Day 65% 7th – 9th Class Day 65%
26th – 30th Class Day 25% 13th – 14th Class Day 45% 10th – 11th Class Day 45%
Summer Term 10 week DROP & ADD POLICY
Last day to DROP a course without a “W” grade (2nd Class Day) 100% refund After 30th Class Day 0% 15th – 16th Class Day 25% 12th – 13th Class Day 25%
DROP after 2nd Class Day – “W” grade 0% refund After 16th Class Day 0% After 13th Class Day 0%
ADD POLICY - Last day to ADD a class – 3rd Class Day

SEND OR FAX TO: Operations Unit * P. O. Box 5247 * Mississippi State, MS 39762 * FAX 662-325-2657
Mississippi State University does not discriminate on the basis of race, color, religion, national origin, sex, sexual orientation or group affiliation, age, disability, or veteran status.

For AOCE Office Use ONLY________________________________

 DROP Code: ______________________________ Refund Percentage: ____________________

 WITHDRAWAL Code: ______________________ Refund Percentage: ____________________

Term: ________ Hrs. Currently Enrolled _________ Effective Drop Date: _________________

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