

REQUEST FOR ACADEMIC BANKRUPTCY
I am hereby requesting that all of my previous college work completed in the Community College System before:
Semester__________ Year_________
be discounted in determining my total college credits and grade point average according to the Community College Senate Rule Section IV, 1.1A. I understand that I may receive credit for some selected courses earned this period without having the quality points earned counted in my grade point average.
Student Name (Printed): ________________
Student ID#: ________________
Date: ________________
Student Signature: ________________
APPROVED:
Advisor's Signature:_________________
DATE: ___________________
Registrar's Signature: _____________________
DATE: ___________________
Processed BY: _______________________________
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