Student School Schedule Form

STUDENT SCHOOL SCHEDULE FORM

This form requests or updates the student course schedule for the upcoming term. Completion and signature constitute a request that the school will attempt to honor in accordance with course availability, graduation requirements, and counseling approval. The information provided will be used for official scheduling and student record purposes. Inaccurate or incomplete information may delay processing.

STUDENT INFORMATION

Student ID:    Grade / Program:

Date of Birth:

PARENT / GUARDIAN CONTACT (IF APPLICABLE)

ENROLLMENT STATUS

Enrollment Type: Full-time Part-time    Expected Graduation Year:

Requested Effective Term Start Date:

REQUESTED SCHEDULE — LIST COURSES BY PERIOD

Enter up to eight (8) preferred course selections. The counselor will resolve conflicts and assign final rooms/teachers.

ALTERNATE SELECTIONS / CONFLICTS

SPECIAL REQUESTS & ACCOMMODATIONS

COUNSELOR USE ONLY

Counselor Name:    Office/Extension:

Counselor Notes (schedule adjustments, approvals, unresolved conflicts):

Counselor Initials:    Verification Date:

ACKNOWLEDGMENTS & CERTIFICATIONS

By checking the box below and signing this form, I certify that the information provided is complete and accurate to the best of my knowledge. I understand that schedule requests are subject to counselor review, course availability, and graduation requirements. I acknowledge the school's policies on schedule changes, withdrawals, and attendance, and accept responsibility for any consequences resulting from inaccurate information or missed deadlines.

I acknowledge and accept the academic policies and schedule change deadlines.

CERTIFICATION

I certify under penalty of school disciplinary action that the information on this Student School Schedule Form is true and that I have provided any necessary documentation to support requested accommodations or program changes. I authorize the counseling office to process this schedule request in accordance with school policy.

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