REQUEST FOR OFF-CAMPUS HOLD
(Complete the following steps, in order.)
Name ______________________________________ Grade ________ Date ___________________
1. Courses you want to drop:
________________________ This class meets: All year 1
st
Sem 2
nd
Sem
________________________ This class meets: All year 1
st
Sem 2
nd
Sem
________________________ This class meets: All year 1
st
Sem 2
nd
Sem
________________________ This class meets: All year
Courses you want to add:
_____Off Campus Hold_____ This class meets: All year 1
st
Sem 2
nd
Sem
________________________ This class meets: All year 1
st
Sem 2
nd
Sem
2. Please note that in order to be eligible for one or more periods of Off Campus Hold, seniors
should fill out the request below.
Please explain why you need Off Campus Hold. If you are making the request due to attendance
on a college campus, please list those classes here and attach a copy of your paid college
registration.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
3. Parents must read and sign: I have read the Request for Schedule Change listed above. I am
aware of the schedule change limitations in the CHS Student Handbook and understand that this
change may not be allowed. I am also aware of any effects this change might have on
graduation credits, honor graduate eligibility, scholarship eligibility, completer status, NCAA
eligibility, AAA eligibility, and/or college entrance requirements.
Student Signature ________________________ Counselor Signature ______________________
Parent Signature ___________________________ Daytime Phone________________________
Return this form to the Counseling Center. CONTINUE TO FOLLOW YOUR PRESENT SCHEDULE UNTIL YOU
ARE NOTIFIED OF THE CHANGE (ALL CHANGES ARE POSTED AS LIVE UPDATES ON HOME ACCESS CENTER)
Office use only: APPROVED YES NO
1
st
SemSem
2
nd
Sem
