Admissions & Records Office
570 Golden Eagle Ave, Quincy, CA 95971
(530) 283-0202 – Fax (530) 283-9961
PETITION TO ADD OR DROP A COURSE LATE
Date _____________________________ FRC ID# OR SS #: ____________________________
Last Name First Initial
STEP 1: TO BE COMPLETED BY STUDENT
I am petitioning to: add a course late reinstate in a course late register late
drop a course past drop date other __________________________________
(student is responsible for paying enrollment fees for courses added or dropped late)
Name/Number of Course: _____________________________ CRN Number: _________________
Semester: Fall Spring Sum 20________ CUM GPA:____________________
MANDATORY
Please explain your reason for requesting this petition:
___________________________________________________________________________________
____________________________________________________________________________________________________
Student’s Signature__________________________________________________________________
x
STEP 2: TO BE COMPLETED BY INSTRUCTOR
I support this petition I deny this petition Student has been attending class as of: _______________
(date)
Please state your reason for supporting or denying this petition:
_____________________________________________________________________________________
_____________________________________________________________________________________
Date:________________________________
Instructor’s Signature
STEP 3: TO BE COMPLETED BY CHIEF INSTRUCTIONAL OFFICER
CHIEF INSTRUCTIONAL OFFICER
(REQUIRED AFTER CENSUS DATE)
Approved Denied
_____________________________________
CIO Signature
Date: _________________________________
RECORDS OFFICE USE ONLY
Processed by: ____________________________ Date_________________________________
Revised 10.17.11 LM – Revised 10.8.13, Revised 11.13.13
RE____ RC_____ RD_____
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