MJC Enrollment Services Phone (209)575-6853
EAST 435 College Avenue, Student Services Bldg. 1st Floor WEST 2201 Blue Gum Ave, Yosemite Hall 1st Floor
Today’s Date:
Student Information:
Last Name: First Name: Middle Initial:
Student ID: w Birthdate: Phone Number:
Course Information:
Course Name & Number: Section #: Semester/ Year:
Course start date: Instructors Name
(please print):
04/2019_SJB
Permission to Add After Census
This form is initiated by the instructor and must have Deans signature before being
forwarded to Enrollment Services via inter-district mail or by email to
MJCESeForms@mjc.edu.
ENROLLMENT SERVICES USE ONLY
Sta Initials: Date: Census date: Backdated add:
REASON FOR LATE ADD: Check ONE.
Instructor/ Dean Use Only
Student’s First Date of Attendance:
APPROVED DENIED Instructor Signature: Date:
APPROVED DENIED Dean Signature: Date:
I acknowledge the late add does NOT override pre-registration holds, prerequisites, corequisites, disqualication,
unit limitation, or nancial aid obligations.
Student Signature: Date:
Pending Prerequisite Challenge, Time Conict or Third Enrollment. Attach approved form.
Student has been attending and actively participating in the class prior to census date.
Student has not been attending prior to census date.
click to sign
signature
click to edit