Pass / No Pass Option Form
To use this form, you need to be currently enrolled in credit classes
(
Please print clearly, using blue or black ink):
AHC Student ID Number
Student’s Last Name Student’s First Name
H
CRN (ie 12345) Course Title & Name (ie DANC 120, Ballet) Name of Instructor: (ie Smith)
S
tudent’s Complete Telephone Number: ________________________________________
Student’s Complete Email Address: ________________________________________
Student’s Signature (mandatory): _______________________________________ Date: __________________
My signature verifies that I have read the instructions and have adhered to the published deadlines to select this option. I agree to
s
ign and return this form to the Admissions and Records office by the Pass/No Pass deadline (each course has a specific
deadline – please verify the deadline via the class search function within the online credit schedule). If mailing the form, it must be
received by the deadline.
This box for Admissions & Records use only: Semester/Year: _____________
Received by: _________ Date received: ___________ Date entered: __________ Entered by: __________
Instructions for selecting the Pass / No Pass Option:
A
s the student it is your responsibility to:
1. P
ick up the form from the Admissions & Records office, or download it from www.hancockcollege.edu
, complete, and sign it;
2. Li
st the correct CRN, course name and number (ie – 12345 DANC 120, Ballet);
3. R
eturn the completed form by the deadline posted within the online credit schedule of classes.
By submitting this form, I understand the Pass / No Pass option policy and I elect to receive a P or NP grade in the course that I have
identified on this form. I understand that it is my responsibility to verify whether or not the course is offered with the Pass / No Pass by
checking the current college catalog or conferring with an AHC counselor. I also understand that it is my responsibility to verify if the
Pass / No Pass option is available within my major degree work or if it is transferable to a four-year college or university.
I also understand that the Pass / No Pass option is not reversible for any reason and after submitting this form to the Admissions &
Records office I may not change my mind at a later date and request a letter grade.
If you are unable to submit this form in person, you may mail it to:
Allan Hancock College
Admissions and Records Office / Request for P/NP Option
800 South College Drive
Santa Maria CA 93454-6399
adm
issions_help@hancockcollege.edu
