K
Office of Enrollment Services, 4000 Lancaster Drive NE, Building 2, Room 200,Salem, OR
Mailing Address: PO Box 14007, Salem, OR 97309-7070
Phone: 503.399.5001 Email: registrar@chemeketa.edu
Student Grade Repeat Request Form
CLEAR
1. If you repeat a course and receive a higher grade, you may request that your original grade be
changed to an “R” mark
2. Fill out the below form and turn it into the Enrollment Center in Building 2, Room 200 on the Salem
campus with photo ID to request your grade be updated in your record
a. You may also email a completed and scanned copy of this form from your MyChemeketa
email address to registrar@chemeketa.edu
3. Please note that both the original and repeated course must be taken through Chemeketa Community
College to qualify for a grade change
4. Both the original and repeated course must be equivalent courses
5. If you repeat a course more than once, only your original grade can be changed to an “R”
a. If you repeat a course and receive a lower grade then both grades will remain on the transcript
b. An original mark of “M,” “X” or “W” or a grade of “I”, “N”, “NP”, or “P” may not be changed
by repeating the course
6. Once a grade has been changed to an “R” it cannot be reversed
7. Some four year universities may treat the “R” mark differently when reviewing your Chemeketa
transcript
a. It is recommended you speak with an advisor before requesting an “R” mark
8. If you are receiving veteran’s education benefits, you should be aware that this may affect your
benefits. Contact Veteran Services (Bldg 2, Rm 200, veterans@chemeketa.edu) before making the
request.
Student ID (K#): Date: - -
Name:
Last, First, Middle
Address:
Street, City, State Zip
Cell Phone with Area Code Email: @my.chemeketa.edu
Course Subject & #: Title: Credits:
(example MTH 095)
Original grade term: Course repeat term:
(example Fall 2014) (example Fall 2014)
Course Subject & #: Title: Credits:
(example MTH 095)
Original grade term: Course repeat term:
(example Fall 2014) (example Fall 2014)
Original grade of: B
C
D
F to be changed to: R
Student Signature: _ _ _
Office Use Only
Chemeketa Community College is an equal opportunity/affirmative action employer and educational institution. To request this publication in an
alternative format, please call 503.399.5192.
Verified number of takes and original grade First Check: Date:
Grade(s) retained for course(s) above:
