Fillable Form 9: SCHEDULE CONFLICT PETITION (Cuesta College)

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Form 9: SCHEDULE CONFLICT PETITION (Cuesta College)

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Registration Office
(805) 546-3955
www.cuesta.edu
SCHEDULE CONFLICT PETITION
Complete this form to request enrollment in two classes that conflict in meeting days/times. The instructor who will provide
make-up activity must complete Step 3 (see below and back of form). Submit completed form to Registration Services for final
review by the Director, Admissions & Records. If approved, you may enroll in conflicting class online in myCuesta within add
deadline. Approved petitions may be viewed in myCuesta Registration Status under Steps to Success channel. If denied, the
student will be notified via their myCuesta student email. All information must be completed below. Attach additional paper if
necessary.
Term: Fall Spring Summer YEAR: 20____
STEP 1
Provide justification or extenuating circumstance below that requires you to enroll this term in courses that
conflict. Scheduling convenience is not an acceptable justification or extenuating circumstance.
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STEP 2
List the information below for the classes in which you wish to enroll that conflict. You will need to obtain approval
from the Division Chair and the Academic Dean, in addition to the instructor of the course for which you will MAKE
UP TIME.
Class for which you will miss time:
CRN: ______________ Subject/Number: _________________
Date begins: ______________ Date ends: ________________
Meets: M T W R F S ___________________ and
M T W R F S ___________________
Class for which you will not miss time:
CRN: ______________ Subject/Number: _________________
Date begins: ______________ Date ends: ________________
Meets: M T W R F S ___________________ and
M T W R F S ___________________
How much time, per week, will you be missing class? _________________ hours and ____________________ minutes
STEP 3
For the class you will MAKE-UP TIME outside class, you must obtain the instructor’s permission below.
INSTRUCTOR: Title V Sections 55007/55056 require that conflicting hours be made-up outside of class under the supervision
and control of a certificated employee (faculty who meet minimum qualifications in service area.) Hours made up outside of
class must be for instruction, not homework. Instructor must document instructional hours outside of class during the same
week of the course. The required documentation detailing how weekly missed time will be made-up must be completed prior
to Division Chair and Dean signatures.
PLEASE USE THE REVERSE SIDE OF THIS FORM
STUDENT IDENTIFICATION NUMBER
9
FIRST NAME M.I. LAST NAME
updated 1/09/2014
Step 3: SCHEDULE CONFLICT PETITION
Documentation by Faculty
To be completed prior to required signatures
DescripƟon of how Ɵme will be made up each week:
Date of AcƟvity Approved AcƟvity Hours
By signing below; I consent to fulfill the projected agreement:
Student’s Signature _________________________________________ Date _________________
Instructor’s Signature _______________________________________ Date _________________
Approved Denied Division Chair’s Signature _____________________________________ Date: _____________
Approved Denied Academic Dean’s Signature ____________________________________ Date:_____________
STEP 4
Return completed form to Registration Services on SLO (building 3100) or NC campuses (building N3000).
OFFICE
USE
ONLY
Approved Denied Comments: __________________________________________________________
A&R Director or Designee Signature _________________________________________ Date: ____________
(SFASRPO: Conflict + CRN) Processed by: _________ Date: ____________
Student Emailed Notification Copy to Division Chair Office Copy to Faculty for documentation
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Form 9: SCHEDULE CONFLICT PETITION (Cuesta College)

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Completed 4 September 2020

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