Repeat Course Permission Form | Paul D. Camp Community College

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 a Dean's approval. The following student/course registration for the term 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 Information

First Name *

Last Name *

Student ID (Empl ID) * Enter your 9-digit student ID number

Course Information

Class Number *

Subject *

Number *

Section

Campus

Previously Taken with Grades

List all previous attempts at this course.

Grade — Attempt 1

Semester / Year

Grade — Attempt 2

Semester / Year

Grade — Attempt 3

Semester / Year

Mitigating Circumstances Provide a detailed explanation of any circumstances that affected your course performance.

Student Success Plan Outline the specific steps you will take to successfully complete the course.

Dean Approval

Approved Disapproved

Dean Signature Date

For the Office of Admissions Use Only

Processed By Date

* Required fields