This form requires a signature and cannot be transmitted electronically. 
Please complete the application, print, sign, and return to the Dean of Admissions.   

In accordance with VCCS and PDCCC Policy, enrollment in a VCCS course is normally limited to two completion enrollments.

Under mitigating circumstances, students may be approved for additional course registrations with the Academic Director's approval. The following student/course registration for the semester has exceeded the normal two completion limit. Please indicate your approval/disapproval for the current registration and provide a summary of the mitigating circumstances for courses that are approved.

Student's Name:

Social Security # --

Student ID Number (Pin #)

Course
Dept:     Course #     Section         Campus

Previously taken with grades of and

Mitigating circumstances:

 

 

 

 

Approval

Disapproval

  Date:
Signature of Academic Director (sign above)

 

  Date:
 Signature of Director Student Development/Services (sign above)

    

Return to Index Page
LAN Administrator
Copyright © 2000 [Paul D. Camp Community College]. All rights reserved.
Revised: July 17, 2007
Director of Student Development Services e-mail jstandahl@pc.vccs.edu