NEW RIVER COMMUNITY AND TECHNICAL COLLEGE
ACADEMIC FORGIVENESS REQUEST FORM
Date________________________________ Student ID Number_________________________
Student Name_____________________________ Major__________________________________
_____ I affirm I have not been enrolled in college on a full-time (12 or more credit hours) basis at any
higher education institution for a period of four (4) consecutive years immediately preceding my
current admission at New River Community and Technical College and that I have been fully
admitted to New River as a degree seeking student and have not been awarded my first
academic degree.
List the period of time you were not enrolled in a higher education institution
________________________ through _________________________________
(List period of time you were not enrolled in higher education month/year through month/year.)
Please check your choice of evaluation
_____ I wish all D and F grades earned before the time period listed above that do not meet the intent
of the D/F repeat rule to be exempted from my GPA calculation for graduation purposes only.
All D grades that are exempted will not be used for credit towards graduation requirements.
While the exempted grades and credits are excluded from transcript calculations, they remain
as part of the official transcript and academic record.
_____ I wish all F grades earned before the four year time period listed above that do not meet the
intent of the D/F repeat rule to be exempted from my GPA calculation for graduation purposes
only. All D grades previously earned will be used for credit toward graduation requirements and
cumulative grade point average calculation. While the exempted grades and credits are
excluded from transcript calculations, they remain as part of the official transcript and academic
record.
______________________________________________ _______________________________
Student Signature Date
_____________________________________________________________________________________
Date to Registrar________________________ Date of Admission________________________
Current Student___________ (yes/no) Confirmation 4 yr of inactivity _________ (yes/no)
Major_________________________ 12 hr with > GPA 2.0 _________
(yes/no)
Eligible for Forgiveness ______ (yes/no) Date Forgiveness granted _______________________
__________________________________________
Registrar Signature
RO
06/08/2020
By typing my name below, I understand and agree that this form of electronic signature has the
same legal force and effect as a manual signature.
To submit this form:
Email
: jschofield@newriver.edu | Fax: 304-929-6719 | Mail: 280 University Drive, Beaver, WV 25813
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