Office of Undergraduate Education
College of Letters and Science
University of California, Santa Barbara Qtr________ Adv________ LI____ LO____
RETROACTIVE ADD
TO BE COMPLETED BY STUDENT:
___________________________________________________ ________________________________
LAST NAME FIRST NAME MIDDLE INITIAL PERM
___________________________________________________ (_______)________________________
U-MAIL ADDRESS PHONE
COURSE:____________________________________________________ QUARTER:_______________________
Department Course # *enrollment number
GRADE OPTION:
P/NP LETTER
*See Department office or appropriate Schedule of Classes
INSTRUCTOR'S STATEMENT
TO BE COMPLETED BY INSTRUCTOR:
The student listed above completed the course ___________________________________________
Department Course #
in _________________________. Units____________________
Quarter/Year (variable-unit courses only)
Instructor's Name ___________________________________________
(please print)
__________________________________________________________
Instructor's signature Date
___________________________________________________________
Department’s signature Date
(If department’s approval for final enrollment is required. Check “Restrictions” in GOLD.)
-over-
RA
click to sign
signature
click to edit
To Students who are seeking RETROACTIVE ADDITION
to one or more courses
Changes are not commonly made to the academic record after the conclusion of a term.
You must submit a written request and a statement from each instructor whose course
you want to add.
Your written request (reverse side of this form) must include the following:
1. Your name, perm number, u-mail address, and telephone number.
2. Identification of the course(s) you wish to add and the academic term(s) affected.
3. An indication of when you began attending the course and your level of participation
in it.
4. An explanation of what prevented you from amending your program before the end
of the term.
Additional comments from the instructor are often helpful, but you should understand
that the final decision rests with the Dean of the College of Letters and Science.
You must submit your written request, the instructor statement(s) and any
additional documentation together.
Please note that if a petition is approved and a course is added to a student’s record,
the instructor must enter a grade in eGrades for the course. The student should
follow-up with the instructor, requesting that the grade be recorded.
If your request is approved, a $3.00 processing fee will be charged to your BA/RC
account for each course.
RETROADD PET
9/10/20