NA Removal Request
Complete this form to request removal of an NA from a student’s record if an NA was reported in error or the student
began attending and can reasonably complete the course requirements. NA grades may not be removed if the student
never attended or if the student began attending after 20% of the course has met. This information will be sent to
Financial Aid Services once processed and scanned into the student’s record.
Student Name_____________________________________________ Student ID Number_________________
Course and Section_______________________________________________ Section Index Number ________________
Semester_____________________________________ First date of attendance ________________________________
Can the student reasonably complete the course requirements? Is the student still attending?
Yes
No
Yes
No
If the student is no longer attending, what is the last date of attendance?_____________________________________
Faculty Signature ___________________________________________________________________ Date ___________
Division Chair/Dean: I approve request and will forward this request to the registrar.
Yes No
Division Chair/Dean Signature ________________________________________________________Date ____________
Registrar: This request falls within compliance standards and will be processed.
Yes No
Registrar Signature _________________________________________________________________Date ____________
