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
05/2020 _SJB
Positive Attendance Add
Submit completed form to Enrollment Services via email at mjcESeforms@mjc.
edu.
Today’s Date:
Student Information
First Name: Middle Initial: Last Name:
Student ID: w Date of Birth: Phone Number:
Course Information
Term/Year: Fall Spring Summer
SECTION # COURSE NAME & NUMBER ACCESS CODE REFUND DATE
1001 MBUSAD 201 1234 09/01/2019
I understand I can add a positive attendance course at anytime. However, per Title 5 & YCCD Board Policy drops
and refund dates still apply.
Student Signature: Date:
INSTRUCTOR USE ONLY
Date student rst attended class:
Instructor Signature: Date:
OFFICE USE ONLY
Sta Initials: Date: ID Veried:
Comments:
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