Enrollment Services
Records and Registration
One University Drive
Camarillo, CA 93012
Phone: (805) 437-8500
Student Mathematics Remediation Contract
CSU Channel Islands students who failed to successfully complete developmental math classes within their first year of
attendance and have not done so due to insufficient grades, must complete a Remediation Contract. Prior to enrollment
at
another institution, student must verify that the course(s) is/are equivalent to the appropriate CSU Channel Islands course
(s) in order for the requirement to be met. A grade of "C" or better is necessary. Any non-equivalent course must be
approved by the Mathematics department via Petition for Exception. Students can also meet this requirement by re-
enrolling in the appropriate CSU Channel Islands remedial course(s).
Term/Year Course to be taken: Term/Year Course to be taken:
Institution: Institution:
Subject & Course Number: Subject & Course Number:
Course Title: Course Title:
Please attach a Course Description (if outside institution) Please attach a Course Description (if outside institution)
I understand that I will have a missing documents hold, preventing any change to my enrollment, until official
transcripts are received and evaluated by the University, or until final grades are posted at CSU Channel Islands.
By signing below, I am acknowledging I am aware of all the above requirements.
Student Signature:
Date
Administrative Use Only
Approved
Denied
Date
Math Program Advisor Recommendation:
Program Advisor Signature:
Comments:
Date
University Registrar Signature:
Administrative Use Only-Records & Registration
Processed by:__________
PS Update: __________ Student Notification:__________
(Staff)
(Date) (Date)
G:\AR\30 - RECORDS & REGISTRATION\05 R&R Functions\Remediation\03 - Remediation Forms Revised 5/3/17
Student Name:
Student ID:
I am
aware that I am required to complete
term(s) of remediation in the term.
I will provide proof of successful completion in order to register for the term
.
Admit
Term
