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Personal Information

Full Name *

SMC Student ID *

SMC Email *

Phone Number *

Phone Number, part 1

Phone Number, part 2

Phone Number, part 3

Course 1

1 CRN *

1 Subject *

1 Course No. *

1 Instructor *

Need to add a second course? *

1 Subject: Other *

Please indicate the subject above.

Course 2

2 CRN *

2 Subject *

2 Course No. *

2 Instructor *

Need to add a third course? *

2 Subject: Other *

Please indicate the subject above.

Course 3

3 CRN *

3 Subject *

3 Course No. *

3 Instructor *

Need to add a fourth course? *

3 Subject: Other *

Please indicate the subject above.

Course 4

4 CRN *

4 Subject *

4 Course No. *

4 Instructor *

Need to add a fifth course? *

4 Subject: Other *

Please indicate the subject above.

Course 5

5 CRN *

5 Subject *

5 Course No. *

5 Instructor *

5 Subject: Other *

Please indicate the subject above.

Student Rationale

Please explain why you have been absent from your class(es) *

Please explain how you plan to be successful in your class(es) if you are reinstated *

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No Show Appeal Form