Petition to Repeat a Course

Contact Person: Contact Person: Phone: Contact Phone:

Please read all information before proceeding:

• All boxes marked with * must be filled out or we cannot process your petition.
• Use the comment box to explain your specific situation. Be very clear and concise. This is your only opportunity to speak with the contact person.
• Allow 7-10 working days for processing.
• We will email you with the final decision.

Student Name:*

Address:*

Student ID: (W#)*

Student Email:*

Phone Number:

Course you want to repeat: (Give example)

How many times have you petitioned to repeat this class? Select 1 2 3 4 5

List ALL attempts of this class including Ws, NP (not passing or no credit), and grades A-F:

1st attempt: First attempt semester/year. Grade Received: Select A B C D F P NP W
2nd attempt: Second attempt semester/year. Grade Received: Select A B C D F P NP W
3rd attempt: Third attempt semester/year. Grade Received: Select A B C D F P NP W
4th attempt: Fourth attempt semester/year. Grade Received: Select A B C D F P NP W

USE COMMENT BOX FOR ALL EXPLANATIONS

Select All That Apply:

I took the course twice, and each time received a substandard grade (D, F, or NP).
I want to repeat this class because my grade was a result of extenuating circumstances. (Use comment box.) Students may be contacted for additional documentation or information.
There has been a significant lapse of time since I last took this class.
I want to repeat this class despite receiving a satisfactory grade.
I understand the new grade will appear on my transcript but will
not be calculated into my GPA.

This is a "special class" for Learning Skills (LRNS) that I want to repeat for
one or more of the following reasons:

Continuing success in my other courses is dependent on my repeating this course.
This class will help me meet my Student Educational Plan goals.
You have my permission to discuss this request with Disabled Students Programs and Services (DSPS).

Comment Box
Reason for request text box: