Course Release & Student Information

Please read and complete this form, then click the Submit button to send it to Dr. Gerth.

I understand it is my responsibility to know policies and procedures for Nashville State courses. It is my responsibility to read the Nashville State 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 my instructor has all my pertinent information including complete name, street address, phone number, and a stable email address. Moreover, it is my responsibility to inform my instructor whenever the above information changes during the course of the semester.

I understand that I will be treated according to Nashville State's Attendance Policy found in the syllabus. (Please carefully read the syllabus. This policy may vary somewhat from course to course.)

Please fill out the information form below. You are required to provide the information marked by an asterisk.

Name* 

Email Address*

Primary Phone Number (including area code)*

Street Address

City                                                                                       State 

ZIP Code

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

Please check all courses you are taking from Dr. Gerth this semester.