4/8/13 12:27 PM
Admissions & Records
Course Grade Verification
This form is to be completed if you are seeking to re-enroll in the same course next term. Admissions & Records
requires verification that you will not receive a passing grade during the current term in order to be eligible to register
now for the next term. After the instructor has provided the required information,
you must submit this form to the
Admissions & Records office at any RCCD college on or after your registration date in order to register for this course
Non-Repeatable Courses: Beginning Summer 2012, you will not be able to enroll in most courses more than three
(3) times. Substandard grades (D, F, FW, NC, and NP) and withdrawals (W) are included in your total attempts; military
withdrawals (MW) are NOT included. Enrollments prior to Summer 2012 will be included in the repeat count. The
most recent grade will be the grade calculated into your GPA.
Repeatable Courses: You may not enroll in a repeatable course more than the total number of times listed in the
college catalog.
______________________________________________________________ _________________________
Last Name First Name M.I. RCCD ID# or SSN
(__________)_________________________________ ____________________________________________________
Phone Number RCCD Student Email Address
Today’s Date: ______________________________ Term/Year: SUM_____ FAL_____ WIN_____ SPR_____
Course Name: _____________ Section Number:___________ Location: MoVal Norco Riverside
To Be Completed By Instructor:
If the student ultimately receives a passing grade, notify Admissions & Records at once.
Projected Final Grade: __________________
Instructor Name (please print): _______________________________________
__________________________________________________________ _____________________________
Instructor’s Signature Date
****************FOR OFFICE USE ONLY****************
Registered Waitlisted Updated By: ________________ Date: ___________
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