CHABOT-LAS POSITAS COMMUNITY COLLEGE DISTRICT
Office of Academic Services
ALTERNATE INSTRUCTION CONTRACT (for “One-Student” Section)
(Must be Filled Out for any Overlap Beyond 15 Minutes)
SEMESTER ___________________ YEAR __________
STUDENT’S
FULL NAME ______________________________________________________ W # _____ _____ _____ _____ _____ _____ _____ _____
OVERLAP COURSE 1: __________________ ________ ___________ OVERLAP COURSE 2:
________________ ________ ___________
Subject (e.g. PE 48) Section CRN Subject Section CRN
WHICH COURSE WILL YOU BE MISSING? COURSE 1 CO
URSE 2
TOTAL NUMBER OF HOURS PER WEEK HOURS PER WEEK
STUDENT WILL BE RECEIVING
ALTERNATE INSTRUCTION:
LIST DAY(S)/HOURS WHEN MISSED TIME W
ILL BE MADE UP: DAY(S)________________________ HOURS/TIMES_________________________
ALTERNATE INS
TRUCTIONAL TOPICS (What are you teaching that is being made up?)
Description of what the student will be expected to do as an outcome of the topics:
Responsibilities assumed by the instructor (What commitments regarding homework, testing, grading, or additional outside-of-class time
does the instructor make?)
ALTERNATE
INSTRUCTION BEGIN DATE:_______________________ EXPECTED DATE OF COMPLETION: ___________________________
___________________________________________________________
FACULTY NAME (Please Print)
___________________________________________________
________ ___________________________________________________________
FACULTY SIGNATURE DATE STUDENT SIGNATURE DATE
Revised 11/14/11 (O
ffice of Academic Services)
APPROVAL OF AGREEMENT:
__________________________________________________________
DIVISION DEAN DATE
__________________________________________________________
VICE PRESIDENT, ACADEMIC SERVICES DATE
ALTERNATE INSTRUCTION CRN:
Assigned by Office of
Academic Services
Any supporting documentation (i.e. Summary of Completed
Work) should be retained by the Division office.
