Fillable CONTRA COSTA COMMUNITY COLLEGE DISTRICT (Los Medanos College)

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CONTRA COSTA COMMUNITY COLLEGE DISTRICT (Los Medanos College)

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File type: PDF

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AR PET 11.21.19
CONTRA COSTA COMMUNITY COLLEGE DISTRICT
Registration Form
Admissions and Records Office
Contra Costa College Diablo Valley College Los Medanos College
Student ID Number Term/Year:
Fall 20___Spring 20____Summer 20____
Last Name (Please print clearly) First Name Middle Name
Course Adds
Section
Course
Units
Time
Add Authorization
(Instructor Signature)
Comments
Example:
0001
Engl-001A
3
1-3PM
Only required once the class
begins
Office use only
Course Drops Reasons
Section
Course
Reason
Example:
0001
Math-120
CM
By registering for courses and signing this form I agree to:
• Assume financial responsibility for any charges and/or fees posted to my account.
• Assume responsibility for understanding college policies concerning schedule changes and their impact
to refunds, financial aid, and VA eligibility.
• Review “My Class Schedule” in InSite for drop and refund deadlines and college catalog for other policies
and procedures.
• Check my InSite email account for important messages.
Student Signature:______________________________________ Date: _______________
CA: CA Residency Issues
HM: Health/Medical
CN: Course not needed
CH: Childcare
TD: Class is too difficult
WO: School Workload
TC: Course/Textbook Costs
IN: Instructor Issues
TR: Transportation
TM: Time Management
FH: Food/Housing Challenges
OT: Other
Processed by: _____________ Date: ___________
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CONTRA COSTA COMMUNITY COLLEGE DISTRICT (Los Medanos College)

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Completed 5 September 2020

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