SSSP Exempt
dgr 10/22/15
CHABOT COLLEGE
LAS POSITAS COLLEGE
EXEMPTION FORM for (SSSP) Student Success and Support Services
NAME: STUDENT ID
NUMBER:
PHONE: E-MAIL:
Complete this form if you do not intend to participate in Assessment, Orientation
and/or create a Student Education Plan (SEP).
Although your chances for success at LPC/Chabot are greater if you participate in all of the SSSP matriculation
components you may exempt from any or all services if you meet the cri
teria listed below. Any
student exempted from these components still has the option of later participating in these services.
**CAUTION: Students who exempt from Assessment, Orientation or SEP
will NOT obtain priority registration status.
**
I am requesting exemption because: (Select one)
OFFICE USE ONLY
Action taken:__________________________________________________________________________
Reviewed by:______________________________ Date:_____________________________________
I am only enrolling in courses mandated by industry or licensure standards
Student Signature:
Date:
I have already earned an AA/AS degree or higher (at a U.S. accredited college or
university)
Submit this form in person to the Counseling Office Room 1616 or
Fax to (925) 424-1402
I am taking courses for personal enrichment only and do not plan to attain a certificate,
degree or basic skills (i.e., English, Math, ESL)
Title 5-55532. Exemptions.
Districts may adopt policies that exempt a student from orientation, asessment, counseling, advising or student educational plan
development if the student:
1. Has completed an Associate or higher degree, or
2. Is taking classes for personal enrichment only and does not intend to earn a degree or certificate, or
3. Has completed these services at another community college with a time period identified by the district, or
4. Has enrolled at the college solely to take a course that is legally mandated for employment as defined in section
55000 or necessary in response to a significant change in industry or licensure standards, or
5. Has enrolled at the college as a special admit student pursuant to Education code section 76001.
I am a high school concurrent enrollment student
I do not plan to transfer to a college or university
