Request To Repeat Course For Third Time
7/31/2015 EM
(email completed form/information to jlyle@tcl.edu)
Today’s Date:______________________________________________
Student Name:_______________________________________________
Student TCL ID Number:_____________________________________
Student Phone #1:_____________________________________________
Student Phone #2:_____________________________________________
Student Email #1:_____________________________________________
Student Email #2:_____________________________________________
Course to be Repeated:_________________________________________
Last Semester Course Was Taken:_______________________________
Advisor:_____________________________________________________
Major/Program of Study:_______________________________________
Supporting Documentation Attached:
(please redact any SSN’s before you scan docs)
TSUM: Test Summary
STRK: Student Remarks
STAC: Student Academic Credits
NOTES: