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    Sign up for Spring

    Find your success - enroll now! Spring classes start Jan. 17. Click on the photo to get started.
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    Textbook Scholarships

    Scholarship drawing for $250 towards your textbooks- deadline to enter is Jan. 7
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    Name the Falcon

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    Class schedule now online

    The Spring class schedule is online now! Click on the photo for more info.
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    Winter Break

    The college will be closed for Winter Break Dec. 24-Jan. 1.
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    Auditions for Spring Play

    Falcon’s Eye Theatre auditions for its spring production of "Cloud Nine" Mon., Feb. 2
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Home >  Student Services >  Admissions & Records >  Admissions & Records Forms

Forms (Downloadable)

Click on a link below to download and print a PDF version of the form you need. These forms can be faxed to the FLC Admissions & Records office at (916) 608-6569 for processing.

Note: To view the forms, you will need to install Adobe Acrobat Reader onto your computer.

Admissions & Fees
AB 540 non-residency exemption form - for those students who attended a California high school for 3 or more years and graduated - but have left the State, returned and have lost California residency / provides for exemption of non-resident fees until residency is re-established

Advanced Education Packet - for high school students who would like to enroll in college classes with proper approval

Residency Reclassification Application (and Instructions) - for students who are requesting a residency reclassification

Records
Course Repeat Petition - use this form when petioning to repeat a class, either after standard grade or 3 previous attempts of substandard grades.

CSU GE/IGETC Certification Request - use this form when needing a CSU GE or IGETC certification for your transfer institution.  This must be done with a counselor.

Exceed Unit Petition - use this form when petitioning to exceed the maximum unit limit during a semester or summer session.  This must be completed at the college where the enrollment is exceeding the district's unit limit.

Late Add Petition - use this form to add a course after the deadline set by State law, district policy or college practices and procedures.

Parental Affidavit for Academic Information - for parents who are requesting to access educational records of their child (without direct student consent) / child must be dependent as indicated on most recent Federal Income Tax Return

Pass/No Pass Petition - use this form to change grading basis of a class from letter grade to Pass/No Pass / must be turned in to A&R by published deadline each semester

Prerequisite Challenge Application - use this form when challenging the prerequisite of a course

Prerequisite Math Clearance form - effective Spring 2015, math enrollment is blocked unless the student has met the prerequisite through valid Los Rios assessment placement or completion of Los Rios course that is prerequisite.  If prerequisite was taken outside of Los Rios and is on the approved external credit list - or - AP test scores provides proper placement, this form should be used (submit to Admissions & Records Office with official transcript or official AP test score).  If the class/college is not on the external credit list, student must go through Prerequisite Challenge process (see form above).

Reinstatement of Priority Registration Request Form - students with more than 90 degree-applicable units completed within the Los Rios Community College District and students with two consecutive major terms on probation (or be on dismissal status) will no longer be eligible for priority registration. Students may appeal this loss of priority registration each term for the reasons listed on the appeal form only. You must provide the required documentation for consideration of your appeal.

Request to Withhold Directory Information - use this form to "opt-out" or request to withhold disclosure of student directory information, per FERPA (Family Rights and Privacy Act) provisions

Student Consent for Release of Records/Request for Records Access form - use this form to approve release of your educational records to a third party, such as parents

Student Petition - use this form to request an exception to college policies such as drop after deadline, refund exception, etc. Click on this link for guidelines about submitting a Student Petition.

Substandard Grade - Repeat Notification Form - use this form to request that a course repeat be noted on your transcript (when course is repeated at a college other than FLC)

Time Conflict/Class Overlap Petition - use this form to request enrollment in a course which occurs at the same time as another course.

Veterans' Affairs

FLC - VA Statement of Student Understanding - this form is part of the enrollment process in order to receive VA educational benefits

FLC – VA Request for Certification form - this form should be submitted to FLC A&R every semester in order to use VA educational benefits

FLC - VA Intake form - this form should also be submitted when initiating your VA educational benefits