Fillable FillablePetitionDropWITHWafterDeadline9112018NB Academic Council Petition [add,drop,refund]

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FillablePetitionDropWITHWafterDeadline9112018NB Academic Council Petition [add,drop,refund]

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Student responsible for understanding information on all pages of documents. Page 1 of 2
Updated: 11.19.12 NB
Filename: OAR(\\Ishtar)/A&R Forms-Petitions/Petition-Drop with “W” after Deadline
Please return to A&R for
processing
Admissions & Records Petition
Drop a Class Late WITH a “W”
______________________________________________
Student Name
______________________________________________
Mailing Address
______________________________________________
City State Zip
Rec’d By:
Date:
Petition refers to:
Fall 20 ____
Spring 20 ____
Summer 20 ____
______________________________________________
Date of Birth
______________________________________________
SCC Email Address
______________________________________________
SCC ID#
CRN.# Course # Course Name Instructor Signature
CRN # Course # Course Name Instructor Signature
CRN # Course # Course Name Instructor Signature
(Required) Student Explanation Please be specific and attach relevant documents if applicable:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Student's Signature Date Telephone No.
OFFICE USE ONLY
Admissions and Records Director or Designee Approve? Y N Notification Email? (Initials/date) _________________________
Comments:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
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Student responsible for understanding information on all pages of documents. Page 2 of 2
Updated: 11.19.12 NB
Filename: OAR(\\Ishtar)/A&R Forms-Petitions/Drop Class Late with “W” Please return to A&R for processing
Drop with “W” Information and Instructions
Only under verifiable extenuating circumstances (i.e., accident, illness, or other
circumstances beyond control-legitimate, supporting documentation required) may
students drop or have fees refunded after the “W” deadline. An appropriate medical
provider’s statement on their official letterhead is required to support medical reasons.
Employment related reasons must be supported by a statement from employer on
company letterhead verifying (1) the student's new work hours and (2) the fact that this
change in schedule is a condition of continuing employment or other explanation if
applicable.
If you missed the deadline to drop a class with a “W” due to verifiable extenuating
circumstances, and the term has not yet ended, it is appropriate to complete this
petition.
This petition can no longer be accepted once a term has ended. If a student wishes to
appeal a class after a term has ended, he or she must appeal to the professor using a
Change of Grade petition.
Instructions:
1. Complete form
2. Submit to Admissions and Records
3. Admissions and Records will review and email student’s copy to their SCC email
within ten (10) business days.
4. If approved Admissions and Records will process in Banner causing change to be
reflected on student’s transcripts.
5. Admissions and Records will post copy to student’s permanent record.
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FillablePetitionDropWITHWafterDeadline9112018NB Academic Council Petition add,drop,refund

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Completed 15 November 2019

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