Concurrent Enrollment Form
Schedule of Classes: tritonlink.ucsd.edu
Concurrent Coordinator: concurrent@ucsd.edu or call (858) 534-3400
Office Use Only
SI#:________________________
DATE:______________________
INT.________________________
Last Name: ________________________________ First Name: _____________________ Student I.D./PID#:_____________________ Quarter:_________
Addr­ess: ________________________________________ City: ________________________________
State: ___________ ZIP: ____________________
Phone: Day: __________________________________ Evening: _____________________________ Email Address: ________________________________
Course Title:_____________________________________________________________________________________________________________________
Instructor:_________________________________ Department:___________________________________________________________________________
Subj.: _______________ Sec. I.D. #: _________________ Course #: ___________________ Sec. #: ___________________ Units: ____________________
Does this course require Academic Computing Services? (Check all that apply)_ q TED Access
­
q Lab Resources
If you are uncertain, please consult with your instructor.
Are you a UC student? q Yes
Grading Option:
q No
q Letter Grade
Have you been dismissed from the University of California or withdrawn from a UC
while on academic or disciplinary probation? q Yes q No
Why are you taking this course? (check one) q Work related
q Personal Interest
q P/NP For Undergraduates
q Degree Requirement
q Other_________________________________________________________________________________________
Enrollment card must be approved by instructor and/or department before your enrollment will be processed by
UC San Diego Extension.
q S/U For Graduates Only
q NFC Not For Credit
Grading option will default
to a letter grade if box is
left unchecked.
Instructor’s signature and/or department stamp: X______________________________________________________
UC San Diego Instructors: I have interviewed this student. I feel he/she is qualified, and class space is available. Permission is granted for enrollment.
Instructions for Completing the Concurrent Enrollment Form
• Clearly complete the front of the enrollment card correctly, and verify that the subject, six-digit section ID, course, section and
course title is accurate.
• Incomplete enrollment cards will not be processed.
• Choose a grading option for the course: P/NP (pass/no pass) is for the undergraduate only. Pass is equivalent to a C- or better. S/U (satisfactory/unsatisfactory) is for the graduate students. Satisfactory is equivalent to a B- or better. Certain courses have restricted grading options and there are limitations on P/
NP credit. Refer to the UC San Diego General Catalog.
• UC San Diego Add/Drop cards will not be accepted in lieu of the UC San Diego Extension Concurrent Enrollment Forms.
• You have until the end of the second week from the first date of the quarter to enroll without penalties. After this period you will
pay a $50 late fee per course.
• Your enrollment is not guaranteed at any time. You are responsible for adhering to all procedures and for returning all necessary forms, petitions and
fees on or before the deadline dates.
• Refer to the UC San Diego Extension Concurrent Enrollment brochure or website for exact enrollment and/or refund deadlines.
• You will be required to pay for tech and/or lab fees at time of enrollment if course instructor has requested these services.
Tech fees are not refundable.
• Concurrent Enrollment deadlines vary, and are subject to change. Deadlines are specific to Concurrent Enrollment; Extension deadlines do not apply.
• All fees are subject to change.
• Enrollment is open to anyone who has completed high school. Students currently attending high school should consult their high school principal or
counselor to obtain written approval, which must accompany their registration card. The approval must be signed by a school official on school letterhead. Students who were dismissed from the University of California or who have withdrawn from a UC while on academic or disciplinary probation are
not eligible for concurrent enrollment.
Return your enrollment form to the UC San Diego Extension Student Services Office with your enrollment fee. Submit one form per class.
Faxed or mailed forms will not be accepted. Concurrent enrollment is closed after the third week of the quarter.
By signing below, I have read, understand and agree to the policy and procedures listed above and I am aware of the Concurrent Enrollment deadlines (including grading
options and refund policies).
I acknowledge students who participate in CE must have a cumulative GPA of 2.0 or higher from their home institution.
Participating in this educational program does not in itself provide preference in admission to the University of California degree programs. Students interested in applying
to UC degree programs should refer to the UC Admissions website or the admissions office of the UC campus they wish to attend for details about the admissions process.
Student Signature ______________________________________________ Date _______________________________
SP15-4042