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FOLSOM LAKE COLLEGE FOLLOW INSTRUCTIONS ON PAGE TWO (Folsom Lake College)

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02/19 Page | 1
FOLSOM LAKE COLLEGE FOLLOW INSTRUCTIONS ON PAGE TWO
Late Add Petition
Student ID Number
Payment Method:
(A&R Staff Only)
BOG Payment after approval
Please complete the following. PRINT legibly and clearly.
Received by/date:
NAME DATE
DAY PHONE *Students will be notified of petition outcome via your LRCCD Email Address.*
① Notice to Student:
A student will only be allowed to add a class after census for extenuating circumstances as defined by Title 5, section 58004 (verified cases of
accidents, illness, or other circumstances beyond the control of the student). The instructor’s approval, as well as the approval of the Area
Dean, is required. Please see the back of this petition for more detailed instructions. No add slip is required, but all fields must be complete.
② Course Information (see instructions)
Term
(e.g. Fall 2014)
Session
(e.g. Full Term, or 2
nd
8-week etc.)
Class Number
(e.g. 11111)
③ Student’s Justification of Request (Justification must be consistent with the description in ① above. Attach supporting documentation if possible. )
_________________________________________________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________________________________________________________
I understand that it is my responsibility to fulfill all requirements of this class.
Student’s Signature Date
④
Required Additional Signatures:
INSTRUCTOR RECOMMENDATION --
Student has been in continuous attendance since the first day of the course.
-OR-
Student has been attending since ___________________________________________.
Student’s First Day of Attendance
Recommend Do Not Recommend Instructor’s Signature/Date ___________________________
DEAN RECOMMENDATION –
Student meets criteria set forth in Title 5, section 58004, as extenuating circumstances.
Recommend Do Not Recommend Dean’s Signature/Date _______________________________
Administrator Use Only
Your petition has been reviewed and your request has been: No Action Approved Denied
Administrator’s Signature Date
Processed E-mailed
Action Taken Processor’s Initials/Date & Comments
02/19 Page | 2
Late Add Petition Instructions
P
URPOSE OF THE FLC LATE ADD PETITION
The Late Add Petition provides students an opportunity to be added to a course beyond the deadline set by state law,
district policy or college practices and procedures. See the FLC Catalog for policies related to your request. Deadline dates
are mandated by the State of California and are not arbitrarily set by the college. Consideration of exceptions to policies is,
therefore, a very serious matter. Exceptions will be granted when extenuating circumstances (accident, illness or death in
the family) beyond the control of the student prevented adherence to the published deadline dates. Not being aware of the
deadline is not an acceptable reason for seeking an exception. Students must take personal responsibility for adhering to all
published dates.
INSTRUCTIONS
Add a class after the deadline
o Complete student information section at top of petition and Sections ①, ② (all including first day of
attendance), ③, ④ (Instructor and Area Dean signatures). No add slip is required, but all fields in ②
must be completed.
o Please turn in this petition to the FLC Admissions & Records office, or at the Student Services offices at EDC
or RCC.
Do not use this petition form for the following requests:
Academic Renewal – Form available in Counseling.
Request for Course Repetition (repeat after standard grade, or third repeat after substandard grade) – Form
available in Admissions & Records or online.
Grade Change - Must be initiated with faculty who issued the grade.
Time Conflict – Form available in Admissions & Records or online.
Student Petition – Form available in Admissions & Records or online.
P
LEASE NOTE:
You will be notified by e-mail of action taken
within 5 business days after you have submitted your Petition.
Math, Science, CIS, Library &
Engineering
G. McCormac / Asst. L. Santoro
FL4-128 (FLC main)
(916) 608-6700
Visual & Performing Arts,
Language & Literature
B. Snowden / Asst. M. Quintell
PAC Dean suite (FLC main)
(916) 608-6621
Business
Social & Behavioral Sciences
& Humanities
B. Robinson
FLC backup: G. McCormac
RCC (Rancho Cordova Center)
(916) 361-6321
FL4-128 (FLC main)
Career & Tech Education
V. Maryatt / Asst.
FL2-144 (FLC main)
(916) 608-6927
Kinesiology, Health, Athletics
M. Wright / Asst. J. Croff
G-180 (FLC main)
(916) 608-6687
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FOLSOM LAKE COLLEGE FOLLOW INSTRUCTIONS ON PAGE TWO (Folsom Lake College)

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Completed 4 September 2020

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