Grade Improvement 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:

___________________________________                     _____________________________________________
(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 __________________