Fillable LMC Late Add Petition- Form DVC (Los Medanos College)

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LMC Late Add Petition- Form DVC (Los Medanos College)

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LMC Pittsburg Office
LMC Brentwood Center
(925) 473-7500
(925) 513-1625
Revised 9/10/2015
Late Add Petition
Instructions:
1. Students will use this form for late registration after the last day to add a course if they did not enroll during
the registration or late add period.
2. The petitioning student must take this form to Admissions & Records no later than 5 business days after
the census date for approval and registration into the course.
To Be Com
pleted by Student:
Student Name: __________________________________________________ Student ID: _______________
Last Name First Name Middle Initial
Phone: ________________________ Email Address: ____________________________________________
Please indicate which term: Summer Fall Spring Year 20______
List Course:
Course Name
Course Number
Section Number
Units
Instructor Name
Detail
ed reason for registering after the deadline: ________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
____________________________________________________ __________________________________
Student Signature Date
To Be Com
pleted by the Instructor:
Recommend approval Recommend Disapproval
List Census Date for Course: __________________ Student’s First Date of Attendance: _________________
List reason for recommendation of Approval: ____________________________________________________
________________________________________________________________________________________
____________________________________________________ __________________________________
Instructor Signature Date
To Be Com
pleted by the Approving Manager (Dean or A&R Director):
Approved Denied
Comments: ______________________________________________________________________________
____________________________________________________ __________________________________
Manager Signature Date
Office Use Only:
Processed By:____________________________________________ Date __________________________
Census Date: _______________
Return By: _______________
The student's first date of attendance must have been prior
to census.
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LMC Late Add Petition- Form DVC (Los Medanos College)

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Completed 21 July 2020

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