LOS ANGELES HARBOR COLLEGE
GENERAL PETITION
Instructions:
1. Type or print in black or blue ink.
2. State request and reasons fully and clearly.
3. Submit petition to the Admissions Office Window, room SSA 107
LAST NAME FIRST NAME MIDDLE NAME
DATE
STREET ADDRESS CITY STATE ZIP CODE
STUDENT ID NUMBER
SUBJECT
TELEPHONE #
STATE REQUEST AND REASONS (use reverse side of sheet or additional pages if necessary):
It is the student’s responsibility to attach transcript(s) and course description(s).
GRANT COMMENTS:
I) NonFTES number assigned. Highest grade earned and completed will be used in the calculation of grade point average
upon completion of second repeat. All grades earned will show on transcript.
II) Official transcript must be mailed directly to the Admissions Office from the University or College to receive credit.
III) Official AP report from the College Board must be mailed directly to the Admissions Office to receive credit.
Other Comments:
FOR OFFICE USE ONLY NOTICE OF DECISION MAILED ON: BY:
SEMESTER & YEAR
STUDENT’S SIGNATURE
DIVISION CHAIR’S ACTION: NOTE COMMENT
DENY GRANT NOTE CONDITION
DIVISION CHAIR’S SIGNATURE DATE
ADMINISTRATIVE ACTION: NOTE COMMENT
DENY GRANT NOTE CONDITION
OFFICIAL’S SIGNATURE DATE
