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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
Course Repeat Petition - use this form when petitioning 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.
English Prerequisite Clearance form - enrollment into ENGWR, ENGED and ENGCW classes is blocked unless the student has met the prerequisite through valid Los Rios assessment placement or completion of Los Rios course that is the prerequisite. If 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 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 below).
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.
Loss of Priority Registration and Fee Waiver Appeal 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. In addition, students with two consecutive terms (fall and spring) of cumulative GPA below 2.0, and/or cumulative course completion of less than 50% may result in loss of fee waiver eligibility. Students may appeal the loss of priority registration or fee waiver eligibility each term for the reasons listed on the appeal form only. You must provide the required documentation for consideration of your appeal.
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
Math Prerequisite Clearance form - enrollment into Math classes is blocked unless the student has met the prerequisite through valid Los Rios assessment placement or completion of Los Rios course that is the 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 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).
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 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.
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