Fillable Special Consid Columbia College

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Special Consid Columbia College

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Columbia College
ATTN: Business Services
11600 Columbia College Drive
Sonora, CA 95370
SPECIAL CONSIDERATION REQUEST PETITION
You will receive an email in your college email account when the Committee has made a decision
on your petition. Incomplete petitions will be returned.
Student Initials
Date:
Name:
Student “w” ID #: Phone #:
Mailing Address:
College E-Mail Address:
Student Signature:
Request:
What action or result are you requesting?
Justification:
What do you feel is the justification for your request? Attach supporting documentation*.
* Physician notes, legal rulings, accident reports
FOR OFFICE USE ONLY
DATE OF RESOLUTION:
REQUEST APPROVED: REQUEST DENIED: NEED MORE INFORMATION:
EXPLANATION IF APPLICABLE:
AR: 11/13
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Special Consid Columbia College

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Completed 11 March 2020

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