Loss Of Priority Enrollment Appeal Form printable pdf download

LOSS OF PRIORITY ENROLLMENT APPEAL FORM

Please print clearly and legibly – Return completed petition and proper documentation to

Admissions & Records (SS-110) or by fax to 805-962-0497.

The California State Legislature requires colleges to adopt enrollment priorities based on factors such as number of units

completed, academic standing, and other considerations. Students who have lost priority enrollment and have been moved to

open registration may appeal to have it reinstated based on verifiable evidence of factors outside their control. The law reads:

“Each community college district shall establish written procedures by which a student may appeal the loss of priority enrollment

due to extenuating circumstances, or where a student with a disability applied for, but did not receive reasonable

accommodation in a timely manner. Extenuating circumstances are verified cases of accident, illnesses or other circumstances

beyond the control of the student. Districts may exempt from the 100 unit limit categories of students, including but not limited

to, those enrolled in high unit majors or programs. Districts may allow students who have demonstrated significant academic

improvement to appeal the loss of priority registration status.” (Title 5, §58108)

_____________________________

_______________

NAME

STUDENT ID #K00

CONTACT PHONE #____________________

TERM___________________________

SBCC

E-MAIL____________________@pipeline.sbcc.edu

I am requesting a one-time reinstatement of my priority registration for the following reason(s):

Check all that apply.

Extenuating Circumstances

Approval is based on evidence of extenuating circumstances, such as verified cases of accident, illnesses, or other

circumstances beyond your control. You must provide documentation, which may include such items as medical

documents, death certificates, newspaper articles, statements from professionals on letterhead paper, etc.

I have a disability and require priority enrollment as a disability related accommodation

Contact Disabled Student Programs and Services (DSPS) for an appointment with a Disability Specialist to review

your request PRIOR to submitting this appeal form. You must attach a letter of verification signed by a DSPS

Specialist.

Enrollment in courses required for a high unit major or program

High unit majors and programs generally include, but are not limited to, STEM (Science, Technology, Engineering

and Mathematics) fields. You must attach a Comprehensive Education Plan detailing one of the listed high unit

programs.

Academic and/or progress improvement

Students who lose their priority enrollment due to academic or progress probation must demonstrate significant

academic improvement to appeal the loss of priority registration status. Evidence of such improvement is defined

as achieving no less than the minimum GPA (2.0) and progress standard (less than 50%) for the term or terms.

Student’s Signature:_____________________________

Date:_______________

OFFICE USE:

Approved

Denied

Administrator Signature:____________________

Date:_________

3/2014

Loss Of Priority Enrollment Appeal Form

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