Birth Date
Phone #
Action Taken: _____ Approved _____ Denied Claim Apportionment: _____ Yes _____ No
Select the exception you are petitioning under:
Previous grades received:
Disability Resource Center (DRC)
A student may not receive more than 3 W's in a course. A petition for a 4th enrollment must result in an evaluative grade.
English Department Writing Center
Extended Opportunity Programs & Services (EOPS)
Health Services
Course repetition is governed by state regulations as described in California Administrative Code, Title 5, Section 55040. Allowable
exceptions include the following (see the reverse for more information on these exceptions).
program has a recency prerequisite (documentation reqd)
Have you used any support services listed below? Please check all that apply.
Director, Enrollment Services
* * * * OFFICE USE ONLY * * * *
Veterans Services
Financial Aid & Scholarship Services
Student Signature
The petition will be reviewed by the Director of Enrollment Services. You will be notified of the decision by email.
Enrollment Services
Petition to Repeat a Course
Palomar ID #
Email Address
Course to be repeated (subject and catalog #, e.g. MATH 60):
Previous attempts (sem/year):
Disability-related accommodation (verification required)
Significant lapse of time (at least three years), and course/
Tutoring Resources
Career Center
Counseling Services
Legally mandated training (documentation required)
Repeatable course (exceeding 4 enrollment limit)
Significant change in industry or licensure standards and
Math Learning Center
Transfer Center
TRIO/Student Support Services
Extenuating circumstances (documentation required)
required for employment/licensure (documentation reqd)
Explain why you need to repeat the course, including what you plan to do to ensure success (attach an additional sheet if
necessary). Attach any required supporting documentation.
Course Rep Petition.xlsx (Revised 7/25/13)
Date Processed/Initials:
See reverse for more specific information.
Be sure to submit with completed
Form - Scroll to Page 2
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Summer Year
Palomar ID Number
Name ____________________________________________
Last First M.I Birth Date
Initial Registration
Class Number Course Faculty Signature*
DROPS (Deadlines on back) Refund Deadline: 13 days after start of class.
It is the student’s responsibility to officially drop classes or be subject to an “F” or “FW” grade.
Class Number Course
Student Signature Date / /
Palomar College
Admissions & Records Office
Enrollment Form
Office Use Only
Student has been participating
since the start date of class or before
the census date and should be
A Student Representation Fee of $1.00 will
provide support for students or
representatives who state positions and
viewpoints before city, county, and district
governments, and before offices and agencies
of the state and federal government. You may,
for religious, political, financial, or moral
reasons refuse to pay the Student
Representation Fee. If you decide not to
participate, please indicate your reason here.
Mo Day Yr
Add/Drop Timetable eServices at
For actual deadline dates, please consult the current schedule of classes.
A Course
First week of instruction
Through 1
Census Deadline
After Census Deadline
If class is closed, secure permission
number from faculty. Use eServices to
add a class.
All semester-length classes require a
permission number to add. Request a
permission number from faculty. Use
eServices to add a class.
Only registration in short-term or open-
entry/open-exit classes is permitted. If
class is closed, request a permission
number from faculty. Use eServices to
add a class.
Refund Deadline: 13 calendar days after start of session
x Are 6-digit numbers that are assigned to students by instructors to authorize enrollment in a class that is closed.
x Are different from class numbers.
x Are UNUSABLE after the add deadline.
DO NOT DELAY in adding your class with permission number. After the deadline dates, you will be required to obtain a faculty
Wait List
If a class is closed, you may place your name on a wait-list (if available). If a seat opens up you will be automatically added. Confirm
your status in eServices.
Dropping A
The No Notation deadline is the day
before Census Day.
Use eServices to drop a class. Faculty
permission is not required. No notation or
grade will appear on your record.
The “W” GRADE deadline is 50% of
days in session.
Use eServices to drop classes. Faculty
permission is not required. A “W” grade
will appear on your record.
The “EVALUATIVE” GRADE period is 51% of
days in session or after.
No drops are allowed during this period. An
evaluative grade (A,B,C,D,F, FW) or “I” must
be given.
No Pass
30% of days in session.
Complete P/NP grading form
and return to Admissions
A Class
Not all classes are available for auditing. Secure application for audit and return to
Admissions Office. Requires faculty, department chair and and dean signature. If
changing from credit to audit status after the refund deadline, no enrollment fees will be
refunded and the $15 per unit audit fee will be charged. There is no deadline for original
registration under audit status.
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