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ADMISSIONS & RECORDS OFFICE
4667 TELEGRAPH ROAD, VENTURA, CA 93003 PHONE: (805) 289-6457
POLICY
Request must be filed in the Admissions & Records office by the eighth week of the semester. All transfers must be
approved by the receiving instructor. Transfers must be approved by the division dean if the request is initiated by the
instructor.
Section 1: Section / Level Change for Spring 20____ Summer 20____ Fall 20____
A&R 3/19/20
REQUEST TO CHANGE COURSE SECTION OR LEVEL
Student Name: ___________________________________________________ Student ID: 900______________
Email: __________________________________________ Phone Number: (______) ________ - ___________
ADD Course Name & Title: __________________________________ CRN: _________ Instructor: ________________
DROP Course Name & Title: _________________________________ CRN: _________ Instructor: ________________
Reason for requesting a change: _______________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
S
tudent Signature: _______________________________________________________ Date: _____________________
Instructor Name: __________________________ Instructor Signature: __________________________ Date: ________
D
ean Name: _____________________________ Dean Signature: _____________________________ Date: __________
A&R Office Use Only: APPROVED DENIED Initial: _______ Date: _______
Section 2: Receiving Instructor Approval Approved Denied
Section 3: Division Dean Approval
(Required if request is initiated by instructor)
Approved Denied
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