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Updated: 4.3.14 LCP
Filename: OAR(\\Ishtar)/10-11 Recal/A&R Forms-Petitions/Petition-Late Add 4.3.14.LCP
Please return to A&R for processing
Admissions and Records Petition Rec’d By
Late Add (After Census) Date
Petition refers to: Fall 20 Spring 20 Summer 20
_______________________________________________ ___________________________________________
Student Name Date of Birth
_______________________________________________ ___________________________________________
Mailing Address SCC Email Address
_______________________________________________ ___________________________________________
City State Zip SCC ID#
Term: _________________ CRN#_____________ Course Name/#______________________________________
STUDENT MUST PROVIDE WRITTEN EXPLANATION AND/OR SUPPORTING DOCUMENTATION
Be specific and attach relevant documents that explain why you are requesting to be added after the deadline
___________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
____________________________________________________ _____________________________ ________________________
Student’s Signature Date Telephone No.
TO BE COMPLETED BY THE INSTRUCTOR AND APPROPRIATE DEAN:
Student has been attending the class prior to the census date but could not register due to:
_______________________________________________________________________________________________________
Instructor Signature Print Instructor’s Name Date
________________________________________________________________________________________________________
Dean Signature Print Dean’s Name Date
Students not actively attending class prior to the census date may not register for class.
OFFICE USE ONLY
Processed in Banner? Y N Initials _____________ Date ____________
Notification Email? Y N Initials _____________ Date ____________
Comments:
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