Los Angeles Community College District
Loss of Enrollment Priority and/or BOGW Fee Waiver Appeal
Last Name: ________________________ First Name: __________________________ Student ID# _________________
LACCD Email: __________________________________________________ Phone: ( ____) ____________________
ALL APPEALS MUST INCLUDE THE FOLLOWING, along with the required documents, below:
A typed explanation of your situation AND an approved, current LACCD Comprehensive Educational Plan (2+
Enrollment Priority Appeal Reasons (check one)
Academic/Progress Probation - Extenuating Circumstances: verified illness, accident or circumstance beyond the control the
student. (Examples of documentation are doctor’s notes, accident report, etc.)
I am making significant academic improvement by completing my last semester with a 2.00+ GPA, and have completed more
than 50% of my semester coursework.
I am a student with a verified disability who applied before the deadline but did not receive an accommodation in a timely
manner (Attach verification of disability document from DSP&S).
I am a Foster Youth or Former Foster Youth who qualifies for an exemption from both loss of Enrollment Priority and loss of
BOG waiver (Written verification from Foster Youth Program must be attached).
Loss of BOGW Fee Waiver Appeal Reasons (check one)
Academic/Progress probation - Extenuating Circumstances: verified illness, accident or circumstances beyond the control of the
student or other circumstances that might include documented changes in the student’s economic situation.
(Examples of documentation are doctor’s notes, accident report, loss of job, etc.)
ve been making significant academic improvement by completing my last semester with a 2.00+ GPA, and have completed
more than 50% of my semester coursework.
I am a
student with a verified disability who applied for but did not receive an accommodation in a timely manner. (Attach
verification document from DSP&S)
s unable to obtain essential support services. (Attach a written statement detailing the circumstances)
I am requesting special consideration as a student in one of these programs: (Attach written verification of program
participation) CalWorks DSP&S EOPS Veterans
e not enrolled at LACCD for two consecutive semesters (fall/spring) since I became ineligible for my BOGW Fee waiver.
(Attach unofficial transcript)
I declare under penalty of perjury that all information on this form is true and correct. I understand that this appeal is void should I fail to make academic progress.
Student Signature: ____________________________________ __ ____ Date:_______________ __________
Committee Review Date:
Committee Recommendation: Approved Denied Semester GPA Cumulative GPA
Support Services/Follow up Recommended:
Authorized College Official Signature: _______________________________ ____ Date:___________________ _