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Form IV.D.1: Overload Course Deferral Request
Use this Form to request that your compensation be deferred for any overload courses. This form
must be submitted before the first day of class of the overload course.
Last First Middle Initial
OVERLOAD COURSE INFORMATION
Course Number: Location:
Semester: Year: Date Class Begins:
I consent to the deferral of all compensation for the above-indicated courses. I understand that any
changes to my election to defer compensation for the above course must be submitted prior to the
first day of class. I have read and agree to follow the policies and procedures found in the Board
Policy Manual Section IV.D.1.(i). and applicable Chancellor Procedures.