,
Last First MI
Date:
Student Petition for Academic Renewal
Petition to Waive College Regulations AP 4240
Student Phone #:
Student Name:
Student Email:
Student CR ID#:
A period of at least two years must have elapsed since the time the coursework to be renewed was
completed. A minimum of 20 units, including all degree-applicable coursework at any regionally accredited
institution with a GPA of 2.0 or higher must have been completed since the most recent term being
renewed. Courses taken at another institution must be documented with an official transcript.
Academic renewal by College of the Redwoods does not guarantee that other institutions will approve such action.
Reason for request:
Please list all terms and courses for which you are requesting Academic Renewal. You may select
a maximum of two terms and 24.0 units for Academic Renewal. College of the Redwoods requires
approval from a CR Advisor/Counselor prior to submission of form to Admissions & Records.
Student Signature
CR Advisor/Counselor Signature
<academic.renewal.petition>
print date 02/17/2017
Date Date
Approved
Denied
Evaluator Signature
Example: Biol-1
General Biology
3.00
2016S
D
Total Number of Credits:
PRINT
CLEAR
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