5.9.12
PALO VERDE COLLEGE
PETITION FOR COURSE REPETITION
Course to be repeated:
Course Code_____________ Course #______________ Course Title ________________________________Term/Yr_____/____
Previous Terms/Yrs and Grades:
Term/Yr ______/____ Grade________; Term/Yr______/____ Grade________; Term/Yr______/____ Grade______
What will you do in order to be successful this term? ______________________________________________________________
___________________________________________________________________________________________________________________________________
**Course Repetitions could affect financial aid eligibility (copies of all petitions are routed through the Financial Aid Dept).
______________________________________________ _________________________________________
Student Name ID #
______________________________________________ _________________________________________
Address Phone Number
______________________________________________ _________________________________________
Student Signature Date
Office Use Only
Courses may be repeated only under the following circumstances:
Check all that apply:
______ Student has earned a substandard grade of “D”, “F”, “NC”, “NP” or “W” in the above course. (Previous Terms/Yrs and
Grades must be entered as described above)
______ Student may enroll in the above course for the third time and final attempt.
______ Student is on probation and must repeat the course.
______ Student has previously received three (3) “W’s” in the above course. (This petition must be submitted to the /VP of Student
Services for approval as no apportionment can be collected for this enrollment). [__] Approved [__] Denied
VP of Student Services _______________________________ Date _____________________________
______ Student earned a passing grade, and an unavoidable and considerable lapse of time (5+ years) has transpired following the
successful completion of a prerequisite. This course is essential to a student’s continued progress. In this instance, the
petition must be submitted to the VP of Student Service for approval and will do so only after consultation with the
appropriate professor. [__] Approved [__] Denied
VP of Student Services _______________________________ Date: ___________________________
______ The course is required to maintain licenses or certificates for purposes of employment, or courses in public safety, which
require periodic refresher training.
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Petition Granted ______ Petition Denied_______
Counselor’s Signature ____________________________________ Date______________________________
Date Posted on Transcript ____________________________
Comments: _______________________________________________________________________________________________
_______________________________________________________________________________________
