AR 3018 (Rev. 06/2017)
Last Friday before classes
In accordance with Policy AC4 a student may register for the same course a
maximum of two times. A withdrawal is considered a registration. Students are
not permitted to register in a course more than twice unless they have approval
to do so.
To request approval, submit this form to any Student Enrolment Services office
( in person or by fax: 604.599.2086.
Forms will be accepted once the semester timetable is published. The deadline
to submit is the Friday before the first week of classes.
The processing time is approximately 5 7 business days. Approval is not always
granted and an
appointment with an Academic Advisor may be required; this
could extend the processing time.
Regularly check your KPU email account. You will be contacted by email or
If granted, approval is for one semester only. If you do not register for this
course you must submit a new request for a future semester.
Student Information
Student ID
Phone Number
Course (subject & number)
Term & Year
At which campus do you prefer to access Academic Advising Services?
Richmond Surrey Langley Cloverdale
Are you an International student?
Yes No
Please answer the questions on the next page and provide sufficient detail to allow an informed decision.
Office use only
Received by: Name & department (please print)
Date Received
Reviewed by: Name & department (please print)
Date Processed
Request has been:
Denied Approved
Authorizing Signature:
AR 3018 (Rev. 06/2017)
Please answer the following questions (If you need more space you may attach a separate sheet of paper)
1. To what factors do you attribute being required to take this course more than twice?
2. What are your reasons for taking this specific course?
3. How will you ensure your success in this course? What will you do differently?
4. What is your alternative academic plan in the event that you are unable to repeat (or successfully complete)
the course?
5. Additional information you would like us to consider (optional).