Pitzer College Office of the Registrar
Please return this form to the Office of the Registrar or email registrar@pitzer.edu
DEADLINE: If you wish to return for Fall semester, you must submit the form before MARCH 15th; if
you wish to return for Spring semester, you must submit the form before OCTOBER 15th.
Student Name: ____________________________________________ ID Number: ____________________
Contact Phone Number: (Check one) Cell Permanent ____________________________________
Intended Grad Date: _______________ __ I am returning for: FALL 20 ____ ~ or ~ SPRING 20
Month and Year
Current Address:__________________________________City/State________________________Zip________
Is this a change of address: Yes No
Check appropriate address categories (check all that apply):
Permanent Local Billing Temporary (give dates) __________________
PLEASE NOTE: Your last advisor of record will be reassigned to you. If you would like to change your advisor
of record, please submit a Change of Advisor Form, which is available in the Registrars Office and on the
Registrar’s Office web page under forms.
Student Signature: Date: _______________
If you submit this form prior to pre-registration you will be assigned an appointment during pre-registration week. You may
also register for classes after pre-registration week, according to the deadlines listed on the Academic Calendar. You will
also need to have registration clearance from your advisor. Students with holds will not be permitted to register. Hold must
be cleared with corresponding office.
To access the online 5-College Course Schedule or the Registrar Office forms online:
Go to www.pitzer.edu
From the Quicklinks tab, select MyCampus2Portal/Courses
For Registrar forms, select Office of the Registrar--Forms
The Academic Calendar and Pitzer College Catalogue are also available at www.pitzer.edu.
If you have further questions or concerns, please feel free to contact the Office of the Registrar at (909) 607-2650.
If you need housing when you return from your leave, please contact the Residence Life Office at 909-607-3900 or email
s:forms\ return from leave 10/2018
Office Use Only:
Academic Standing: Entered: ______________
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