Undergraduate Student
Reduced Course Load (RCL) Request
SISS Office Use Only:
Eligible for Part-Time - SISS Advisor ________________________
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International students in F-1 or J-1 status must be registered full-time each quarter, excluding summer.
Full-time is defined as 12 units per quarter.
International student must meet with and receive approval from an International Student Advisor before
dropping below 12 units.
Students who plan to take a quarter off (PELP) should not use this form unless the PELP is for
medical reasons. All students planning to PELP must schedule an appointment with an SISS advisor.
Required
Fill out the required section and the boxed section that applies.
Name: _____________________________________________________________ Date of Birth: _______________
Last
First
MM/DD/YYYY
Student ID: ________________________ Phone: __________________________ Email: _____________________
Requested Term:
□ Fall □ Winter □ Spring □ Summer I □ Summer II
Year: ________
Medical Condition
An international student may be authorized for a reduced course load (or no classes at all) due to a temporary
illness or medical condition for a maximum of 12 months. The approval is only valid for one quarter at a time.
Students must reapply each quarter.
Required: Letter, on official letterhead, from a licensed medical doctor (M.D.), doctor of osteopathy (D.O.), or
a licensed clinical psychologist recommending either a reduced course load (less than 12 units) or no enrollment
(0 units) due to a medical condition. The letter must specify the quarter for which the exception to full-time
enrollment is applicable.
Submit the Form Appropriate to Your Situation at the Office of the Registrar:
• Reduced Course Load: Submit a “Part-Time Status” form to the Office of the Registrar if you will be
enrolled in 10 units or less. Application deadline is the 10th day of instruction.
OR
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Leave of Absence: Submit a “Planned Educational Leave Program (PELP)” form to the Office of the
Registrar. Application deadline is the 10th day of instruction in which PELP is to take effect.
OR
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Withdraw from UC Davis: Submit “Cancellation/Withdrawal” form to the Office of the Registrar if you need
to withdraw from UC Davis due to a medical condition. Please note: When you return to UC Davis, you
must file an application for readmission with the Office of the Registrar.
Readmission application deadlines are strictly enforced
Fall Quarter………………………..last business day of July
Winter Quarter…………………….last business day of October
Spring Quarter……………………last business day of January
I hereby confirm the above information is complete and accurate. If there are any changes I will notify my International Student
Advisor at SISS.
Student Signature: _______________________________________________ Date: ________________________________
SISS, UC Davis, University House, One Shields Avenue, Davis, CA 95616
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530-752-0864
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siss.ucdavis.edu
Rev 7/15
Major Advisor
Final Quarter
□ I certify that this student is in his/her final quarter
and will be registered in less than 12 units for: □ Fall □ Winter □ Spring
Year: __________
(SISS understands that the signatures express only an expectation, not a guarantee or confirmation of degree completion.)
Advisor’s Name: ______________________________ Phone: _________________ Email: ____________________________
Dean’s Advisor
Advisor’s Signature: ___________________________________________________ Date: _____________________________
□ I certify that this student is in his/her final quarter
and will be registered in less than 12 units for: □ Fall □ Winter □ Spring
Year: __________
(SISS understands that the signatures express only an expectation, not a guarantee or confirmation of degree completion.)
Advisor’s Name: ______________________________ Phone: _________________ Email: ____________________________
Advisor’s Signature: ___________________________________________________ Date: _____________________________
Student
□ I hereby confirm the above information is complete and accurate. If there are any changes I will notify my
International Student Advisor at SISS.
□ I also understand that I must submit a “Part-Time Status” form with the Office of the Registrar if I will be
enrolled in 10 units or less. Application deadline is 10th day of instruction.
Student Signature: ________________________________________________ Date: ___________________________
Academic Difficulty
Please check the most appropriate reason:
Dean’s Advisor
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An international student may be approved to take less than 12 units due to academic difficulty, but
only based on one of the reasons listed below.
This approval is given one time only per degree program and the student must be enrolled for a minimum
of 6 units.
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Initial difficulties with reading requirements.
Initial difficulties with the English language.
The student will be enrolled for a total of _______ units for
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Unfamiliarity with U.S. teaching methods.
Improper course level placement.
Course Name:_____________________
□ Fall □ Winter □ Spring
Year: _______
Advisor’s Name: ______________________________ Phone: _________________ Email: ____________________________
Student
Advisor’s Signature: ___________________________________________________ Date: _____________________________
□ IStudent
hereby confirm the above information is complete and accurate. If there are any changes I will notify my International
Advisor at SISS.
□ I also understand that approval for a reduced courseload due to academic difficulty does not allow me to change to part-time
status for tuition purposes according to the policy of the Office of the Registrar.
Student Signature: _______________________________________________ Date:___________________________
SISS, UC Davis, University House, One Shields Avenue, Davis, CA 95616
●
530-752-0864
●
siss.ucdavis.edu
Rev 7/15