Eastern Iowa Community College District
Registration and Course Transfer Agreement Form
Summer 2008
Fields with a
*
are required.
*
Date:
*
I will be attending
(please select one)
:
Clinton
Muscatine
Scott
*
Name -
Last:
First:
Middle:
*
Address:
*
City:
*
State:
*
Zip Code:
*
Telephone Number:
(please include your area code)
Address at which you wish to receive registration confirmation
(if different from above)
:
*
Birthdate:
*
E-mail Address:
*
Program of Study:
*
New Student
(or)
Returning Student
Class(es) in which you wish to enroll:
Computer #
Catalog #
Course Name
Time
Day(s)
Bldg/Room
Credits
*
College currently attending:
*
Address:
*
State:
*
Zip Code:
It is my understanding that upon the completion of the courses listed above at Clinton, Muscatine or
Scott Community College for the 2008 Summer term, my transcripts will be forwarded to the
"College currently attending" indicated above. I have the necessary course pre-requisites for these
courses and understand the transfer status of the course(s) that I plan to complete.
PLEASE NOTE: Submitting this application is considered the same as a written signature.
*
I accept the above statement:
Refunds
Students who withdraw from the class(es) and complete the necessary procedure will be entitled to a refund of tuition
according to the following schedule:
75% Refund - prior to the end of the first week of classes (2
nd
class day of summer and short-term sessions)
50% Refund - prior to the end of the second week of classes (5
th
class day of summer and short-term sessions)
Students who are receiving financial assistance and completely withdraw are subject to the current refund policy
regarding the return of funds to the applicable programs.
Any changes made to your original schedule may affect your Promissory Note plan.
Contact the Business Office for details.
