Nashville State Technical Community College"
Video Orientation Release Form

I have viewed the Video orientation clip and understand it is my responsibility to know policies and procedures for video based courses.

It is my responsibility to read the Nashville State Technical Community College Student Handbook and be aware of all registration dates, drop/add dates, last day to withdraw without penalty dates, and the last day to drop a course and receive a "W" dates.

It is my responsibility to make sure that each instructor has all of my pertinent information including complete name, street address, phone number, and a stable email address.

It is my responsibility to return each set of videotapes to the Library Circulation desk or off-site location on or before the last day of final exams each semester or I will have to pay a $25 non-refundable late fee for each set of late returned tapes.

I understand that if I do not make contact with each instructor I have registered with every 2 weeks, beginning from the first day of the semester, that I will be dropped from the course with a grade of "WF" (withdraw failure).

Student Name

Email

Re-enter Email

Home Phone Number including area code 

Cell Phone Number including area code

Street Address

City   State    ZIP

Nashville State Tech complies with the Americans with Disabilities Act. If you wish to request any accommodation(s) for this class, please notify the instructor as soon as possible.

I do do not select one request ADA accommodation(s) for my course.

I select one do do not give my permission for my grades to be sent to me via email.

Course Number  DSPM 0800 Select course

Date:

By clicking the submit button you are verifying that you understand and agree to the terms stated in this document.