EOPS Student Appeal Los Angeles Southwest College
Name
*
First Name
Last Name
ID
*
Student Email
*
Ex. student1234@student.laccd.edu
Phone Number
*
-
Area Code
Phone Number
Major
*
Educational Goal (check all that apply):
*
Certificate
Degree
Transfer
Undecided
Units completed at LASC?
*
Have you submitted an EOPS appeal before?
*
Yes
No
Semester requesting reinstatement:
*
Ex. spring 2020, fall 2020
Why were you placed on probation/exited from EOPS?
*
Completed only one (1) contacts
Completed only two (2) contacts
Over 70-degree applicable units/6 consecutive semesters/completed AA/AS degree or higher
Three (3) required contacts not completed for more than one semester
Other
Please explain the nature of the circumstances that prevented you from meeting the terms of the EOPS/CARE Mutual Responsibility Contract. Include the timeline and specific details.
*
What steps have you taken to ensure that you understand and will adhere to the requirements of the program?
*
Date
*
-
Month
-
Day
Year
Date
Signature
*
NOTE:
Student will be notified of a decision within 14 business days of submitting an appeal.
Submit
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