Rev: 3/12/2015
I am requesting an exemption from the following services (check all that apply):
___Orientation : The orientation process provides information regarding MSJC’s
educational and support programs, policies and procedures, including registration
and course selection.
___Counseling : All first time or transfer students are required to meet with a MSJC
counselor to develop a comprehensive or long-term education plan.
All students must participate in assessment/placement, unless a below exemption applies. If you have taken English or
mathematics courses or assessment tests at another college, please see a counselor for assistance. Students must bring
unofficial transcripts or the other college’s placement recommendation to the counselor.
My request for an exemption is based on the following:
Supporting Information
(Office Use Only)
I have graduated from a regionally accredited U.S. college or
university with an AA degree or higher;
Unofficial transcripts or copy of degree
Enrollment Services (initial & date)_______________
Maintain certificate/license, Pursue Educational
Development or 4-Year College Student taking courses to meet 4-
year requirement
NOTE: Student must verify/update education goal on
EagleAdvisor prior to submitting form to Enrollment Services
Verify educational goal of, LIC, EDDEV or 4YEAR in Colleague
Enrollment Services (initial & date)________________
I certify that the information provided is true and correct to the best of my knowledge. I understand that I may
participate in orientation and counseling at any time while I am attending MSJC.
Signature______________________________________ Date:_________________________________
MT. SAN JACINTO COLLEGE
EXEMPTION FORM
-time students are REQUIRED to participate in the college’s matriculation services assessment, orientation, counseling
and the development of a student education plan. Students requesting and receiving an exemption are not req
uired to
participate in the college’s matriculation services (California Code of Regulations§55532). Students receiving a matriculatio
n
ipate in those services at any time but will be considered a
for priority
egistration. Please review the priority registration process located in the current college catalog for more information.
Date:
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