[Type text]
Student
Information
Last Name First Name Middle Student ID # e-mail/phone
Per Board Policy 4226 and Administrative Procedure 4226, students may not enroll in two or more classes where the meeting times overlap,
unless: The student provides a valid justification, other than scheduling convenience, of the need for an overlapping schedule that does not
exceed 10% of class meeting time. The student makes up the overlapping hours at some other time during the same week under the
supervision of the instructor of the course. The Chief Instructional Officer or designee approves and ensures the make-up is arranged.
A
pproval of this petition will require: (1) a rational justification (not scheduling convenience), and (2) a written plan by the faculty member
assigned to the second class indicating the manner by which the student will be required to make up the time of overlap. The missed time
must be made up during the same week at some other established time under appropriate supervision.
Indicate Year & Semester: Year Winter Spring Summer Fall
Overlapping courses (original schedules):
Course #1
Course Name Section Number Meeting Day/s Meeting Time/s
Instructor
Course #2
Course Name Section Number Meeting Day/s Meeting Time/s
Instructor
TOTAL WEEKLY OVERLAP MINUTES (Overlap time between two classes listed above) = ______________________
Modified weekly schedule for overlapping minutes arranged by the instructor (cannot be during a different instructional
assignment office hours may be used for this). Modified meeting time must be equal to overlapping times listed above.
Note: Instructor must keep records to document these weekly meetings and submit this documentation to the Instruction
Office when grades are turned in.
Modified Course
Day Start Time End Time Location
Modified Weekly Schedule
Instructor Signature agreeing to
the modified scheduled
Student Signature:
I agree to make up time and follow my modified schedule
with the instructor of my overlap course.
INSTRUCTION-OFFICE USE ONLY APPROVED DENIED
___________________________________ ____________________________________ _______________
Dean or VPI Signature Printed Name Date
STUDENT ENROLLMENT SERVICES-OFFICE USE ONLY (if request approved)
Processed by: _________________________________ Date: ________________________________
Rev 7-1-15
OFFICE OF INSTRUCTION
3000 Mission College Blvd
Santa Clara, CA 95054
PETITION TO REGISTER IN CLASSES
WITH OVERLAPPING TIMES
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