• CRNCourse NumberCourse SectionCourse TitleInstructorCredits 
  • I have met any prerequisite and/or corequisite courses that may be required for any of the above courses. (Attach transcript or grade report if prerequisite/corequisite courses were taken off-campus.) (See back of this form if registration waivers are necessary.) I accept responsibility for the selection of and payment for the courses as indicated above. I have read and understand the Refund/Withdrawal Policy. NOTE: I understand that I must fulfill my financial obligation two weeks before the start of the semester, or my registration will be voided and my classes deleted. (See payment options below.) I agree that by registering for courses within the Community College System of New Hampshire (CCSNH), I am financially obligated for ALL costs related to the registered course(s). Upon a drop or withdrawal, I agree that I will be responsible for all charges as noted in the student catalog and handbook. I further understand that if I do not make payment in full, my account may be reported to the credit bureau and/or turned over to an outside collection agency. I also agree to pay for the fees of any collection agency, which may be based on a percentage of the debt up to a maximum of 35%, and all additional costs and expenses, including any protested check fees, court filing costs and reasonable attorney’s fees, which will add significant costs to my account balance. (Effective 4-1-14)
  • Date Format: MM slash DD slash YYYY