Modesto Junior College & Columbia College Grade Improvement Request Form

NOTICE OF INTENTION TO REPEAT COURSES
FOR IMPROVEMENT OF GRADE

	Print and fill out this form after registration is completed for the class. Sign and fax, or mail it to MJC or CC:
	Modesto Junior College, Admissions Office 435 College Avenue Modesto, CA 95350 209-575-6853 209-575-6859 - FAX	Columbia College, Admissions & Records Office 11600 Columbia College Drive Sonora, CA 95370 209-588-5250 209-588-5337 - FAX

___________________________________	_____________________________________________
(Social Security # or Student ID #)	(Semester & Year Repeated/ To Be Repeated)

I, ___________________________________ HEREBY SIGNIFY MY INTENTION TO REPEAT

___________________________	___________________________________	IN AN EFFORT TO
(COURSE NAME & NUMBER)	(COURSE TITLE)

IMPROVE MY GRADE OF	_________	EARNED IN	_____________	______
	(D, F, NC)		(SEMESTER)	(YEAR)

AT ___________________________________ COLLEGE.

I have read and understand the qualifications and limitations under repetition of courses for improvement of grade in the current Modesto Junior College or Columbia College Catalog.

_____________________________________________	_______________________
Student's Signature	Date

For Office Use Only Modesto Junior College:

NEW GRADE POSTED ON PERMANENT RECORD AND INFORMATION SYSTEMS WILL BE NOTIFIED OF CHANGES IN ACCUMULATED TOTALS.

_____________________________________________	BY _______________________
(DATE)

For Office Use Only Columbia College:

Request Approved ________ Denied _______ Reason for Denial __________________

Admissions & Records Technician __________________ Date __________________