Select your type of request from this list Drop course(s) during Drop/Add period Withdraw from course(s) after Drop/Add period Withdraw from the college *   Select a school year from this list 2004-2005 2005-2006 2006-2007 2007-2008 *  Select a semester Fall Spring Summer *

                                                First                                            Middle                                         Last
            Your Name: *    

            ECC Student ID (7 Digits):

            Birth Date (in form of 01/01/1981):

            Home/Mailing Address:

            Your Email Address (MyEdge Email Address):* (Request will fail if email address is not given!)

            Home Phone (including area code):* (This number may be called to verify request)

            Best time to call: 

List of Courses You Wish to Drop/Withdraw*

        Course Prefix      Number        Section                          Course Title                                Instructor Name            Ever Attended?
        (ex: ENG)         ( ex: 111)       (ex: L1)
                    Choose Yes/No Yes No
                    Choose Yes/No Yes No
                    Choose Yes/No Yes No
                    Choose Yes/No Yes No
                    Choose Yes/No Yes No

        Name of your advisor:  

        Your Program of Study: Select One College Transfer - Associate in Arts College Transfer - Associate in Science Accounting Business Administration Criminal Justice Early Childhood Early Childhool / Teacher Associate Health Information Technology Human Services Technology Information Systems Internet Technology Manufacturing Technology Medical Assisting Networking Technology Nursing Office Systems Technology Radiography Respiratory Care Auto Body Automotive Systems Cosmetology CT / MRI Electrical/Electronics Facilities Maintenance Industrial Maintenance Mechanical Drafting Medical Transcription Motorcycle Mechanics Surgical Technology Practical Nursing Not On List

         Reason for Request:
       

 
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