Fillable California State University, Los Angeles (California State University, Los Angeles)

Fill Online, Printable, Fillable, Blank California State University, Los Angeles (California State University, Los Angeles) Form

Use Fill to complete blank online CALIFORNIA STATE UNIVERSITY, LOS ANGELES pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

California State University, Los Angeles (California State University, Los Angeles)

On average this form takes 7 minutes to complete

The California State University, Los Angeles (California State University, Los Angeles) form is 1 page long and contains:

  • 0 signatures
  • 0 check-boxes
  • 27 other fields

Country of origin: US
File type: PDF

U.S.A. forms for California State University, Los Angeles

BROWSE CALIFORNIA STATE UNIVERSITY, LOS ANGELES FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
California State University, Los Angeles
Records Office, records@calstatela.edu
Addendum for Petition to Withdraw
Students must complete the 'Petition to Withdraw' form and this Addendum after the regular withdrawal
deadline. Course withdrawals during the emergency withdrawal period are rarely approved and only
permitted in cases such as an accident or serious injury where the extenuating circumstances are
beyond the student’s control and the assignment of an incomplete is impracticable. Therefore, withdrawal
during the emergency withdrawal period will normally involve total withdrawal from all classes due to the
serious nature of the illness or injury.
Last Name: ______________________ First Name:______________________ MI:___
CIN: __________________ Email______________________ Telephone: (____)___________
Procedure after the regular withdrawal deadline
1. Complete the Petition to Withdraw form
2. Attach documentation to support the serious and compelling reason for withdrawing
3. Review
the situation with your Instructor and obtain their approval
4. Review the situation with the Department Chair and obtain their approval
5. Complete the Petition to Withdraw Addendum (this form)
6. Review the situation with the Dean of the College and obtain their approval
7. Make a copy of all documents for your records
8. Submit completed forms and documentation to the Records Office at records@calstatela.edu
9. Continue to attend classes until a decision is made. Once a final decision has been made on
your Petition, an email notification will be sent to your CalStateLA e-mail address
10. If Petition is approved, check GET to ensure the ‘W’ or ‘WE’ grade(s) was recorded
11. If Petition is not approved, you must initiate the incomplete process where applicable or
complete the class
Documentation: Attach any additional information or documentation in support of your request.
Class
Number
Course
Subject
Course
Number
Section Units
Dean of College
Signature
Date
Example:
12345
Example:
MATH
Example:
2400
Example:
01
Example:
3
John Doe
8/18/2016
Attach approvals to your email
when sending to
records@calstatela.edu.
Student Signature: Send from your CalStateLA email account to act as your electronic signature
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

California State University, Los Angeles (California State University, Los Angeles)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 5 May 2022

Message

View Audit Log
Print With Audit Log
Duplicate Document