Fillable LossofPReg.CCPGAppeal - CC Loss Of Enrollement

Fill Online, Printable, Fillable, Blank LossofPReg.CCPGAppeal - CC Loss Of Enrollement Form

Use Fill to complete blank online COLUMBIA COLLEGE (CA) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

LossofPReg.CCPGAppeal - CC Loss Of Enrollement

On average this form takes 7 minutes to complete

The LossofPReg.CCPGAppeal - CC Loss Of Enrollement form is 2 pages long and contains:

  • 2 signatures
  • 15 check-boxes
  • 14 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Columbia College (CA)

BROWSE COLUMBIA COLLEGE (CA) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Note: Foster Youth and Former Foster Youth (up to age 24) are exempt from loss of both priority registration and CCPG per regulation.
Last
Name:
First
Name:
Student
ID#:
CC
Email:
Phone
#:
(
)
‐
‐
Minimum documents that must be included with this form as well as those identified below:
A typed narrative of your situation
A current approved Columbia College Comprehensive Student Educational Plan
I have completed the following (provide date completed):
O
r
ientation
Date:
Assessment
Testing
Date:
Enrollment Priority Appeal Reasons: (check at least one)
Academic/Progress Probation Extenuating Circumstances: verified illness, accident or circumstance beyond the control of the
student (examples of documentation are: doctor’s notes, accident report, etc.).
I have been making significant academic improvement by completing my last semester with a 2.00+ GPA and completed
more than 50% of my semester coursework (attach Probation Contract).
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).
Loss of CCPG: (check at least 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.).
I have been making significant academic improvement by completing my last semester with a 2.00+ GPA and 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).
There was a change to my economic situation (please provide a written statement).
I am a student in one of these programs (circle all that apply). The Appeal Committee will check with each circled program
for any special consideration:
CalWORKs EOPS DSP&S Veterans TRIO Athletics Petitioned to Graduate
I have not enrolled at CC for two consecutive primary semesters (fall/spring) since I became ineligible for my W'
(attach unofficial CC transcript).
This form is to appeal your enrollment priority and/or loss of the CCPG
Loss of Priority Registration and/or California College Promise Grant Appeal
I declare under penalty of perjury that all information on this form is true and correct. I understand that this appeal form is void should I fail to make academic
progress.
Student Signature Date:
OFFICE USE ONLY Level (circle one): 1 2 3 4
Approved
Denied
_Semester
GPA
Semester
Completion
Rate
Support Services/Follow‐up Recommended:
Vice
Pr
esid
ent
of Student
Services
Signature
:
Date:
Loss of Priority Registration and/or California College Promise Grant Appeal Process Instructions
LOSS OF PRIORITY REGISTRATION:
Per Title 5, Section 58108 Regulations of the California Community College System, your calculated academic standing will impact
your assigned registration date for future semesters. A second consecutive primary term (fall/spring semesters) on academic or
progress probation will result in the loss of continuing student priority registration. This will also apply to any student over 100‐unit
limit (excluding non‐degree applicable and ESL courses). This means you would register after all continuing and new students thereby
possibly losing your opportunity for the courses you need to meet your educational goal.
LOSS OF THE CALIFORNIA COLLEGE PROMISE GRANT (CCPG):
Please be aware a student that continues on a second consecutive primary term (fall/spring semesters) on academic dismissal or
progress probation will result in the loss of the California College Promise Grant (CCPG).
1. Complete the student information part of this appeal form and attach a typed narrative of your situation and an updated
Educational Plan. If you do not have an Educational Plan on file, or it needs to be updated, make an appointment to see a
counselor. (If you are Foster Youth you are exempted from this process. Please contact Admissions & Records.)
2. If you are requesting an appeal for Academic/Progress Probation due to Extenuating Circumstances such as verified illness,
accident or circumstances beyond your control, or documented changes in your economic situation, attach your supporting
documentation. (Supporting documentation includes doctor’s notes, accident report, loss of job, etc.)
3. Submit the completed Appeal form to Admissions & Records Office with all of the supporting documentation that is indicated on
the form based on your appeal reason (Appeal Form, typed narrative, Educational Plan, and supporting documentation). Any
missing information will result in your Enrollment Priority/CCPG Appeal form being rejected by the Appeal Committee.
All Appeal forms and documentation must be received by Admissions & Records
before the established due date. Planning ahead is very important!
Due
Dates:
Loss of Priority Registration Appeal: Due Monday before the Priority Registration
date.
Loss of CCPG Appeal: Due by first Friday of the Semester.
REV: KDB 3/14/18
click to sign
signature
click to edit
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

LossofPReg.CCPGAppeal - CC Loss Of Enrollement

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 28 March 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document