8/24/2018
English/Math Placement Waiver
This waiver only applies to courses listed with test score requirements in the Concordance Chart.
CCC ID Number
Date
Student Name
Term
Alpha
Course
Number
Course Title
Central Community College promotes the success of all students.
By signing this form, I acknowledge:
I understand I am registering for a course above the recommended course placement.
I understand it is in my best interest to reach out to my instructor and utilize
tutoring/academic success centers I start to struggle with concepts in the course.
Student
Signature
Parent/Guardian
Signature
(if Early College)
CCC employee who
reviewed placement waiver
with student
Notes:
Completed form needs to be submitted to the Registration Office.
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