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Click on a link below to access a fillable PDF version of the form you need. These forms should be emailed through admissions@flc.losrios.edu, using your Los Rios Gmail account.

Adobe PDFAB 343 Non-Resident Tuition Exemption form (PDF) – Students who have a special immigrant visa and settled in California upon entering the U.S. shall be exempt from paying the non-resident tuition fee for the length of time he or she lives in this state up to the minimum time necessary to become a California resident.

Adobe PDFAB 540, AB 2000 & SB 68 Non - Resident Tuition Exemption form (PDF) – Individuals who have met certain criteria based on previous education within the state of California may qualify for non-resident tuition exemptions provided under State law.

Adobe PDFAdd Drop Request (PDF) – use this form when you are unable to add or drop classes online via eServices. (You must submit using your Los Rios Gmail account).

Adobe PDFChange of Data form (PDF) – use this form when updating name, address, etc.
For Name Changes: Please provide at least two forms of government issued I.D. (one with new name and one with old name) with your request OR a copy of the official name change document from the court.
For Social Security Number Changes: Please provide copy of SSN card. (You must submit using your Los Rios Gmail account).

Adobe PDFCourse Repeat Petition (PDF) – use this form when petitioning to repeat a class, either after standard grade or 3 previous attempts of substandard grades.

Adobe PDFCSU GE/IGETC Certification Request (PDF) – use this form when needing a CSU GE or IGETC certification for your transfer institution. This must be done with a counselor.

Adobe PDFEnglish Prerequisite Clearance form (PDF) – enrollment into ENGWR, ENGED and ENGCW classes is blocked unless the student has met the prerequisite through valid Los Rios assessment placement or completion of Los Rios course that is the prerequisite. If taken outside of Los Rios and is on the approved external credit list - or - AP test scores provides proper placement, this form should be used. Submit to Admissions & Records with official transcript or official AP test score. If the class/college is not on the external credit list, student must go through Prerequisite Challenge process (see form below).

Adobe PDFEnrollment Verification Request (PDF) – to be used when requesting enrollment verifications. (You must submit using your Los Rios Gmail account).

Adobe PDFLate Add Petition (PDF) – use this form to add a course after the deadline set by State law, district policy or college practices and procedures.

Adobe PDFLoss of Priority Registration and Fee Waiver Appeal Form (PDF) – students with more than 90 degree-applicable units completed within the Los Rios Community College District and students with two consecutive major terms on probation (or be on dismissal status) will no longer be eligible for priority registration. In addition, students with two consecutive terms (fall and spring) of cumulative GPA below 2.0, and/or cumulative course completion of less than 50% may result in loss of fee waiver eligibility. Students may appeal the loss of priority registration or fee waiver eligibility each term for the reasons listed on the appeal form only. You must provide the required documentation for consideration of your appeal.

Adobe PDFMajor / Goal change form (PDF) –use this form when updating your major or educational goal. (You must submit using your Los Rios Gmail account).

Adobe PDFMath Prerequisite Clearance form (PDF) – enrollment into Math classes is blocked unless the student has met the prerequisite through valid Los Rios assessment placement or completion of Los Rios course that is the prerequisite. If prerequisite was taken outside of Los Rios and is on the approved external credit list - or - AP test scores provides proper placement, this form should be used. Submit to Admissions & Records with official transcript or official AP test score. If the class/college is not on the external credit list, student must go through Prerequisite Challenge process (see form above).

Adobe PDFPass/No Pass Petition (PDF) – use this form to change grading basis of a class from letter grade to Pass/No Pass must be turned in to A&R by published deadline each semester.

Adobe PDFPrerequisite Challenge Application (PDF) – use this form when challenging the prerequisite of a course.

Adobe PDFResidency Reclassification Application (and Instructions) (PDF) – for students who are requesting a residency reclassification.

Adobe PDFRequest to Withhold Directory Information (PDF) – use this form to "opt-out" or request to withhold disclosure of student directory information, per FERPA (Family Rights and Privacy Act) provisions.

Adobe PDFStudent Consent for Release of Records form (PDF) – use this form to approve release of your educational records to a third party, such as parents.

Adobe PDFStudent Petition (PDF) – use this form to request an exception to college policies such as drop after deadline, refund exception, etc.

Adobe PDFSubstandard Grade (PDF) – Repeat Notification Form – use this form to request that a course repeat be noted on your transcript (when course is repeated at a college other than FLC).

Adobe PDFTime Conflict/Class Overlap Petition (PDF) – use this form to request enrollment in a course which occurs at the same time as another course.