Contra Costa Community College District
Contra Costa College
Diablo Valley College Los Medanos College
Registration Appointment Appeal
Students may appeal their registration appointment only if they have lost their priority
based on probation/dismissal or are over 100 units.
1.
Appeals are accepted during the following registration time periods: Summer March 15-April 15; Fall April 1-30; Spring
November 1-30. You will receive a response by email within 3-5 business days. Please check your college email daily.
2.
Submit the completed Registration Appointment Appeal form and documentation to the Admissions & Records Office
of the college in which you intend to enroll.
3. Attach your current Student Educational Plan (required).
Last Name______________________________ First Name_________________________ ID#_____________________
College Email _______________________@insite.4cd.edu Contact Phone_________________________________
I am requesting an earlier registration appointment for ONE of the following terms:
Summer 20____ Fall 20____ Spring 20____
Check the statement(s) below that applies to you:
I am
on academic or progress probation/dismissal
I have documented extenuating circumstances (verified cases of accident, death, or illness during
timeframe when probation/dismissal occurred, or did not receive accommodations in a timely manner)
OR
I h
ave demonstrated significant academic or progress improvement (2.0 in the last term or 50%
completion)
OR
I have over 100 degree applicable units in CCCCD
I h
ave documented academic extenuating circumstances (change of major, dual major, re-training, second
degree, or did not receive accommodations in a timely manner) OR
I am enrolled in a program of study that requires completion of 100 or more units
J
ustification for Request (Attach additional sheet if necessary). Attach documentation of extenuating circumstances.
___________________________________________________________________________________________________
__________________________________________________________________________________________________
I understand that by submitting this form I am NOT guaranteed an earlier registration date.
Stud
ent Signature_________________________________________________ Date______________________________
I am a DSPS/DSS student and you have permission to discuss this request with DSPS/DSS.
Official Use Only—Do not Write in this Box
_____ Approved ____ Denied Authorized Signature___________________________________________________
Comments:____________________________________________________________________________________________
_____________________________________________________________________________________________________
Original Reg. Date/Time:______________________________ Approved Reg. Date/Time:____________________________
Processed by:_________________________________________________________ Date:____________________________
Revised 10/01/14
Date Stamp & Operator initials
