General Student Petition

Instructions: Please complete all requested information and, where appropriate, attach the original documentation. Please note that in most cases, your request cannot be processed without supporting documentation. If there are extenuating circumstances that you wish to have considered, please explain in the section at the bottom of this form and attach supporting documentation. You are encouraged to attach documentation to support your petition. You must provide all information requested. The General Petition may not be used for a grade change in which the student received a grade of A, B, C, D, F, Pass, No Pass, Credit, or No Credit. The Grade Change Petition process and its forms must be followed and used.

El Camino College will be closed starting Thursday, December 24, 2020 and will reopen for business on Monday, January 4 2021. Forms submitted during this time will not be processed until the office reopens. The standard processing time for your form will start from when we reopen.

Name on ECC Records*

First Name

Middle Name (optional)

Last Name

Date of Birth*

El Camino Student ID Number*

El Camino MyECC Email*

Confirm El Camino MyECC Email *

Course

Term and Year Taken

Instructor's Name

Assigned Grade

Course

Term and Year Taken

Instructor's Name

Assigned Grade

Course

Term and Year Taken

Instructor's Name

Assigned Grade

Please indicate actions you wish considered:

Reason for Petition*

No Show Drop – After the Drop Deadline: This petition is to affirm you did not appropriately drop a course and NEVER attended the class. You received a “W” and are petitioning to have the “W” removed. If you received any other grade (A, B, C, D, F, Pass, No Pass, Credit, No Credit), you must file a Grade Change Petition. Students must make this request within eighteen (18) months after the final day of the term for the affected class. Drop After the “W” Deadline: This petition category requires you to submit documentation supporting the extenuating circumstances that prevented you from dropping your class(es) on or before the deadline date (*Extenuating circumstances are defined as “verified cases of accidents, illnesses or other circumstances beyond the control of the student”. Title V, 55758.) If approved, your academic records will reflect a “W” to indicate a withdrawal. Military Withdrawal: This type of withdrawal may be approved beyond the normal grade appeal deadline. A copy of activation or change of duty station orders will be required as documentation. If approved, your academic records will reflect "MW' to indicate Military Withdrawal. A refund is automatically approved for enrollment fees. Excused Withdrawal (EW): This type of withdrawal may be approved beyond the normal grade appeal deadline. Documentation is required to support the extenuating circumstance as to why the student is requesting an Excused Withdrawal. (Extenuating circumstances defined as "verified cases of accidents, illnesses or other circumstances beyond the control of the student". Title V, 55758) If approved, your academic records will reflect an 'EW' to indicate excused withdrawal. There is no refund with this withdrawal. (EW began Fall 2018 on) Use AP scores for ECC credit. (You must attach a copy of your AP scores.)

Other:

I am requesting a refund for the following item:

Enrollment Fees Non-Resident Tuition

Please explain the reason for your request.*

Documentation Upload*

No File Chosen

File uploads may not work on some mobile devices.

Do you have additional documentation to submit*

Yes No

2. Additional Documentation Upload*

No File Chosen

File uploads may not work on some mobile devices.

2.Do you have additional documentation to submit *

Yes No

3. Additional Documentation Upload*

No File Chosen

File uploads may not work on some mobile devices.

3.Do you have additional documentation to submit *

Yes No

4. Additional Documentation Upload*

No File Chosen

File uploads may not work on some mobile devices.

Signature*

[clear]

Use your mouse or finger to draw your signature above

Date/Time