Refund Of Enrollment Fees Petition Form printable pdf download

Refund Of Enrollment Fees Petition Form

Saddleback College

Refund of Enrollment Fees Petition

Office of Admissions, Records and Enrollment Services

28000 Marguerite Parkway, Mission Viejo CA 92692 (949)582-4555

Instructions: In this petition, you are asking for an exception to college policy and/or state law. Typically, a student must

demonstrate that extenuating circumstances (documented cases of accidents, illnesses or other circumstances beyond

your control) existed.

Please complete all requested information, explain in detail your reasons for requesting an exception and attach

supporting documentation. In most cases, petitions submitted without supporting documentation cannot be approved. If

you need additional space, attach extra sheets to support your petition. Please type or print all information legibly as

incomplete and illegible petitions will not be approved.

Student ID:

Date of Birth:

Date:

Name

Last

First

Middle

Address:

City:

State:

Zip:

Telephone: (

)

Email:

Semester(s)

Year(s)

Course Title(s)

Ticket Number(s)

_______

Refund of Fees: (Please see the schedule of classes or college catalog regarding refund policies.)

Payment of the basic enrollment fee is required pursuant to Education Code § 76300. Additionally, once the term begins, it

is presumed the student has accepted the benefit of instruction from the college and has incurred a debt. A petition for a

refund after the deadline will only be considered due to extenuating circumstances.

Documentation of these

circumstances must be attached to this form. Examples of documentation include medical statements, employment

verifications or news releases of an event, which has affected you directly. Parking permit refunds must be requested

through the Campus Safety Office and accompanied by the parking permit. Material fee refunds must be requested

through the appropriate academic division. (California Code of Regulations, Title 5, § 55204 & 58508)

Student Comments: (use back of paper if necessary)

Student Signature: __________________________________________________________________________________

For Use by Office of Admissions, Records and Enrollment Services Only

Received By _____________

Date Received:

Comments to student:

Director/Registrar: __________________Date__________________ Approved ______Denied _______Pending_______

9/6/2010

Refund Of Enrollment Fees Petition Form

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