J:\STUDENT\GraduationandPublications\Publications\Forms\Withdrawals‐AEG,DE,Medical\deferredstanding.pdf 02/2016 Page1of2
DeferredStandingRequestForm
Registrar&EnrolmentServices
IMPORTANTINFORMATION
Noappealwillbeconsideredwithoutdocumentaryevidenceofextenuatingcircumstances.
Studentswhoareunabletocompletecourserequirementsduetoextenuatingcircumstancesmayapplyto
theRegistrarforadeferredstanding.
DEADLINE:Thedayafterthelastdayoffinalexams.
FromPolicyE2011:WithdrawalfromCoursesandDeferredStanding
Deferredstanding(DE):anarrangementidentifiedbyatemporarynotation(DE)onastudent’stranscript
thatindicatesthatthestudenthasbeengrantedanextensiontocompletecourserequirementsbecause
ofextenuatingcircumstances.
Extenuatingcircumstances:compassionateandexceptionalcircumstancesbeyondastudent’scontrolthat
significantlyaffectthestudent’sabilitytomeetrequirementsofacourse.Suchcircumstancesmay
includethoserelatedtoastudent’sphysicalorpsychologicalhealththatisverifiableanddocumentedby
anappropriatelistedprofessional.
Itisthestudent’sresponsibilitytoreadandunderstandPolicyE2011:WithdrawalfromCoursesand
DeferredStanding,availableontheLangaraCollegewebsiteat:http://langara.ca/aboutlangara/
policies/collegepolicies/studentservices.html
OFFICEUSEONLY
DECISION:
COMMENTS:
INITIAL: DATE:
J:\STUDENT\GraduationandPublications\Publications\Forms\Withdrawals‐AEG,DE,Medical\deferredstanding.pdf 02/2016 Page2of2
DeferredStandingRequestForm
Registrar&EnrolmentServices
PARTA:TOBECOMPLETEDBYTHESTUDENT
PARTB:TOBECOMPLETEDBYANAPPROPRIATEPROFESSIONAL(IFAPPLICABLE)
FULLLEGALNAME:
LANGARAID: TERM:
PHONE: EMAIL:
Iwishtobeconsideredforadeferredstandingforthefollowingreason(s)(attachmaximum2pagedocumentexplainingcircumstances):
Iwishtobeconsideredforadeferredstandingforthefollowingcourse(s):
COURSESUBJECTANDNUMBER:
EXAMDATE:
(IfmissedFinalExam)
COURSEWORKSTILLREQUIRED:





RELEASEOFINFORMATION:LangaraCollegecollectsyourpersonalinformationundertheauthorityoftheCollegeandInstituteAct
[RSBC1996,Chapter52,Section41.1]forthepurposeofprocessingyourdeferredstandingrequest,andincompliancewiththe
provisionsoftheFreedomofInformationandProtectionofPrivacyAct[RSBC1996,
Chapter165,Section33.1].Forquestions
aboutthecollection,useanddisclosureofyourpersonalinformation,contacttheRegistrarofEnrolmentServicesat604.323.5225.
STUDENT’SSIGNATURE:DATE:
AnappropriateprofessionalisanAboriginalElder,anindividualwhoisregisteredwiththeCollegeofPhysiciansandSurgeonsof
BC,aDentistregisteredwiththeCollegeofDentalSurgeonsofBC,aregisteredpsychologistoftheCollegeofPsychologistsofBC,
aNursePractitionerregisteredwiththeCollegeofRegistered
NursesofBC,aRegisteredClinicalSocialWorkerregisteredwiththe
BCCollegeofSocialWorkers;oranequivalentregisteredprofessionaloutoftheProvince.
Thisstudentisunabletocompletecourserequirementsonthedate(s)from______________________to___________________
duetoanextenuatingcircumstance,andinmyopinionshouldbeconsideredforadeferredstanding:YesNo
REASONSFORDEFERRAL(CONFIDENTIAL):
PROFESSIONAL’SSIGNATURE: DATE:
PROFESSIONAL’STITLE:
STAMPORPRINTPROFESSIONAL’SNAMEANDADDRESS:
Mark“Confidential” andsubmitcompletedform to:
Appeals,RegistrarandEnrolmentServices,
LangaraCollege,100West49
th
Ave.,Vancouver,BC,V5Y2Z6
Fax:604.323.5590
Email:appeals@langara.ca
click to sign
signature
click to edit
click to sign
signature
click to edit
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome