Note: Foster Youth and Former Foster Youth (up to age 24) are exempt from lass of both priority registration and CCPG per regulation.
Last Name: _____________________________First Name: ________________________Student ID #_______________
YC Email: __________________________________________________Phone: ( )________-_____________
Minimum documents that must be included with this form as well as those identified below:
A typed narrative of your situation AND an Approved YC Comprehensive Educational Plan
Please indicate which term you are appealing to have your enrollment priority and/or CCPG reinstated
Summer _____ (Year) Fall _____ (Year) Spring _____ (Year)
Copy of transcript
Enrollment Priority and CCPG Appeal Reasons: (REQUIRED check one)
Academic/Progress Probation Extenuating Circumstances: documented illness, accident or circumstance beyond the control
of the student. (Examples of documentation are doctor’s notes, accident report, etc.)
I have been making significant academic improvement by completing my last semester with 2.00+ GPA and completed
more than 50% of my semester coursework.
I am a student with a verified disability who submitted a completed application before the first day of classes or within the
first two weeks of school but did not receive accommodations in a timely manner. (Attach verification of participation in the
DSPS program).
Loss of California College Promise Grant (CCPG): (IF APPLICABLE check one)
I was unable to obtain essential support services. (Please provide a written statement)
I would like to be granted special consideration as I am a student in one of these programs (check all that apply)
(Written verification from each program must be attached to your Appeal form along with specific issue):
_____ CalWORKs _____ EOPS _____ DSPS _____ Veterans
Economic Situation: Approval based on verified evidence of an economic situation, such as eviction, job loss and
homelessness, etc. To be considered, you must provide documentation, which may include such items as an eviction notice,
layoff or termination notice, unemployment statements, and statements from professionals on letterhead stationery, etc.
I declare under penalty of perjury that all information on this form is true and correct. I understand that this appeal form is void should I fail to make academic progress.
Student Signature: ________________________________________________ Date: _____________________________
Counselor Signature: ______________________________________________ Date: _____________________________
Loss of Enrollment Priority and/or California College Promise Grant* Appeal
This form is to appeal your enrollment priority and/or loss of CCPG
*formerly known as Board of Governors Fee Waiver (BOG)
OFFICE USE ONLY Review Date: ____________________________
Approve _____ Denied _____ Semester GPA ________ Cumulative GPA __________
Support Services/Follow up Recommended: ________________________________________________________________________________
Dean of Student Services Signature: _________________________________________________________ Date: ________________________
Student Notification Date: _____________ Financial Aid Office action completed: _____________ A&R action completed: _________________
Loss of Enrollment Priority and/or California College Promise Grant* Appeal
Processing Instructions
*formerly known as Board of Governors Fee Waiver (BOG)
Per Title 5, Section 58108 Regulations of the California Community College System, your calculated academic standing will impact
your assigned registration date for future semesters. A second consecutive term (fall/spring semesters) on academic or progress
probation will result in the loss of continuing student priority registration. This will also apply to any student over 90-unit limit
(excluding non-degree applicable and ESL courses). This means you would register after all continuing and new students thereby
possibly losing your opportunity for the courses you need to meet your educational goal.
Please be aware a student that continues on a second consecutive term (fall/spring semesters) on academic or progress probation
will result in the loss of the CCPG.
1. Complete the student information part of this appeal form and bring a typed narrative of your situation to the counseling
partment to schedule an appointment. When making an appointment with a counselor, let the scheduler know you are
requesting an appeal and will need a comprehensive education plan or will be updating your current education plan.
(Foster Youth: If you are a Foster Youth you are exempted from this process. Please contact the Admissions Office.)
2. B
ring this form with you to your appointment with your typed narrative and supporting documentation.
If you are a CalWORKs, EOPS, student you must meet with the appropriate program Counselor
3. I
f you are requesting an appeal for Academic/Progress probation due to Extenuating Circumstances such as verified illness,
accident or circumstances beyond your control, or documented changes in your economic situation have your supporti
cumentation ready. (Supporting documentation are doctor’s notes, accident report, etc.)
4. Subm
it the completed Appeal form to Admissions & Records with all of the supporting documentation that is indicated on
the form based on your appeal reason (Appeal Form, typed narrative, comprehensive education plan, and supportin
documentation). Any missing information will result in your Enrollment Priority/CCPG Appeal from not being accepted by
Admissions and Records.
Rev 04/2020
All Appeal forms and documentation must be received by Admissions & Records Department by
the established deadline. Planning ahead is very important!
Petitions must be received by the deadlines below
nrollment Priority Appeal: CCPG Appeal:
Summer/Fall: April 1
Summer: July 1
Spring: October 15
Fall: August 1
Spring: February 1
ote: If the above date falls on a weekend or holiday, the appeal is due the following business day.