Course Reinstatement Request Form

A student who is purged from a class due to non-attendance may be reinstated into the class with the instructor’s approval if the student has since started attending the class. Student is to complete and submit this form to obtain the instructor’s permission. After the reinstatement request is approved, the instructor will submit the request to the Registrar’s Office. 


Student's Information
Name:*
Student ID:*
Student's E-mail:*
Confirm E-mail:*

Course information
Course Discipline: *
CRN:*
Course:*
Section:*
Course: Title:*
Instructor:*
Instructor's E-mail:
E-mail confirmation:

To find your instructor's e-mail address, visit the Faculty/Staff Directory.

By signing and submitting this form, you acknowledge that your electronic signature is the is the legally binding equivalent to your handwritten signature. By submitting this form, you hereby request to be reinstated to the above-mentioned course.
Student's Signature*
Date:*