University Petition – Retroactive Change of Unit Value
Under restricted circumstances, a student may petition for a retroactive change of unit value in a class.
This petition requires an explanation of the reason for requesting this change retroactively.
Retroactive Change of Unit Value Petition Fees
To submit petition(s):
•
•
One petition: $20
(one class per petition form)
More than one petition:


AND all petitions are for classes in the same semester:
$20
OR classes being petitioned are in different semesters: $20/semester
After petition decision is made - for ‘Granted’ petition(s) only:
(Note: You will be notified in writing of the applicable back-end fees due.)
The University Petition form which follows is used for several different types of petitions. The following
instructions apply to submitting this form for Retroactive Change of Unit Value.
Instructions for submitting this petition:
1) Download the University Petition and Miscellaneous Fee Assessment forms that follow.
2) Complete the top section of the University Petition form with your personal information.
3) Select Type of Petition: check Retroactive Change of Unit Value
4) Complete Section C – Page 4
5) Fill out the Miscellaneous Fee Assessment form with your name and student ID number.
6) Take both forms to Student Financial Services (UH-180) to pay the appropriate fees (see section above).
7) Submit University Petition form and proof of payment to Admissions & Records (LH-114).
To submit this petition by mail:
•
Follow instructions above for steps 1. through 5.
•
Mail completed University Petition form, Miscellaneous Fee Assessment form and fee payment check
(payable to 'CSUF') to:
California State University, Fullerton
Attn: Student Financial Services
P.O. Box 6808
Fullerton, CA 92834-6808
Download forms that follow: University Petition
Miscellaneous Fee Assessment
Revised 05/01/17
UNIVERSITY PETITION
INSTRUCTIONS: 1) Complete petition form.
PLEASE PRINT CLEARLY
2) Pay fee(s) required to file the petition (see information below)
(PLEASE USE DARK INK – NO PENCIL)
Page 1
3) Return petition and proof of payment to LH-114.
Date ________________________________________
Name ________________________________________________________
CWID _________________________________________
Address ______________________________________________________
Phone ________________________________________
_______________________________________________________________
City
State
Zip Code
Email: ________________________________________
Major _______________________________________
PETITION FEES
To submit petition(s): One petition: $20
More than one petition: AND all petitions are for classes in same semester: $20
OR petitions are for classes in different semesters: $20/semester
After petition decision – for ‘Granted’ petitions only: Certain petition types, if granted, require back-end fees to be paid before the
academic record can be adjusted to reflect the approved petition(s). You will be notified in writing of any applicable back-end fees.
IMPORTANT INFORMATION FOR SUBMITTING THIS PETITION
The University Petition form is used when a student is seeking an exception related to one of the four areas listed below:
- Retroactive Add
- Retroactive Change of Grading Basis
- Retroactive Change of Unit Value
- Other
IMPORTANT:
(1) ONLY ONE request can be filled out on each petition form.
(2) All petitions are subject to review, and can either be ‘Granted’ or ‘Denied.
(3) After your petition has been reviewed, and a decision made, a copy of the petition will be mailed to you.
- Check the box below for the type of petition you are submitting.
- Complete the Section indicated for your petition on the pages that follow.
Retroactive Add (SECTION A – See Pages 2, 3)
Other (SECTION D – Page 4) – Restricted use for the following:
Retroactive Change of Grading Basis (SECTION B – See Page 3)
Catalog year
Retroactive Change of Unit Value (SECTION C – See Page 4)
University upper-division baccalaureate writing requirement
(not major writing requirement)
Any other use of Section D must be prescreened by the Records Office:
Prescreened by Records Office: Date: __________ By:__________
COMMITTEE DECISION
Official Use Only
1. Petition Decision:
Granted
Date: ________________________________
Granted, after payment of additional fee(s) required – please see ‘Additional Fees’ information
at top of this form, and instructions in attached letter.
Denied (please see Comments below)
No Action Taken (please see Comments below)
COMMENTS: __________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
____________________________________
Revised 05/01/17
Page 2
SECTION A – RETROACTIVE ADD
(ONE CLASS PER FORM)
Dept/Course Number ________________________ Taken: Semester/Year __________________________
Schedule #: _________________
Instructor Name: _____________________________________
The standard time periods to officially register for a class* are as follows:
(1) Early registration period (via Titan Online)
(2) Online add period
(1st wk of classes)
(*Time periods listed below are for Fall and Spring semesters.)
(Please note: Having a course professor add you name to Titanium
for a class, this action – in and of itself – does not signify that you
are officially registered for the class.)
(3) Using an electronic permit (2nd week of classes)
(4) Using approved ‘late add’ form w/ dept signatures: (3rd, 4th week of classes)
QUESTION: Did you attempt to officially register for this class during any of the time periods during the semester?
YES – Please answer the questions in SECTION 1 below.
SECTION 1
NO – Please answer the question in SECTION 2 – next page.
Please check the applicable box(es) below to indicate the time period(s) in which you attempted to register for the
class you have listed above.
(1) Titan Online – early registration
(3) Titan Online – using electronic permit (2nd wk of classes)
(2) Titan Online – ‘online add’ (1st wk of classes)
(4) Approved ‘late add’ form w/ dept signatures: (3rd, 4th wk of classes)
Question 1: Based on the time periods you have checked above, please describe the specific steps you took to register for this class:
_________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
Question 2: Why were these steps not successful? ____________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Question 3: If you thought you had successfully registered (but found out later that your efforts had not succeeded), what confirmation did
you have at the time that caused you to believe you were officially enrolled in this class?
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Expected term of graduation (must be in the future) _____________________
Student signature _____________________________________
Page 3
RETROACTIVE ADD, continued
SECTION 2
1. If you did not attempt to officially enroll in this class by means of standard registration procedures, please explain the reason(s) why.
Were there any extenuating circumstances that prevented you from registering by the established deadlines explained on Page 2 of
this petition?
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
2. Please provide any documentation that verifies any attempt you made to register for this class, or documents why you were not able
register for this class using standard registration procedures.
Expected term of graduation (must be in the future) _____________________ Student signature _____________________________________
SECTION B – RETROACTIVE CHANGE OF GRADING BASIS
ATTENTION ALL STUDENTS: CAN ONLY petition to change:
CANNOT petition to change:
(ONE CLASS PER FORM)
FROM: ‘Credit/No Credit’ TO: ‘Letter Grade’
FROM:
‘Letter Grade’ TO: ‘Credit/No Credit’
UNDERGRADUATE STUDENT SECTION
GRADUATE STUDENT SECTION
DEPT/COURSE: __________________ TERM TAKEN: ____________
INSTRUCTOR NAME: ________________________________________
DEPT/COURSE: __________________ TERM TAKEN: ____________
THIS COURSE NEEDS A LETTER GRADE IN ORDER TO MEET A
REQUIREMENT IN:
INSTRUCTOR NAME: ________________________________________
Attached is a copy of my graduate study plan.
General Education: Section on TDA: ___________________
Major: Section within major on TDA this course meets:
I do not yet have a graduate study plan.
_____________________________________________
Minor: Please list your declared minor: _________________
ALL STUDENTS PETITIONING FOR RETROACTIVE CHANGE OF GRADING BASIS – COMPLETE THIS SECTION
Why did you register for this class with a grading basis that you now need to change? _____________________________________________
_________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
Expected term of graduation ______________________________
(must be in the future)
Student signature ___________________________________________
Page 4
SECTION C – RETROACTIVE CHANGE OF UNIT VALUE
Dept/Course Number: __________________
(ONE CLASS PER FORM)
Course Taken: Semester/Year __________________
Schedule Number: __________
Instructor Name: _________________________________
Requesting change in unit value :
FROM: ________ unit(s)
TO: ________ unit(s)
Why do you need to change the unit value for this class? (please continue on a separate sheet of paper, if needed)
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
Expected term of graduation _________________________
Student signature ___________________________________________
(must be in the future)
SECTION D – OTHER
This section is used for:
Upper-division baccalaureate writing requirement (University writing requirement, not major writing requirement)
Catalog year policy
For any request that is not one of the two stated above, this form cannot be used without first speaking to a representative of the Records
Office. There is no guarantee that the exception you are seeking is one that can be petitioned.
Reason(s) for this request – This petition requires a statement that indicates what you are requesting, along with detailed background information
regarding the reason(s) for submitting this request. Please be specific and clear. Please also include relevant documention pertaining to your
request.
Student Request:
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Expected date of graduation _________________________
(must be in the future)
Student signature ___________________________________________
California State University, Fullerton - Office of Admissions and Records
MISCELLANEOUS FEE ASSESSMENTS
OFFICE USE ONLY
WEB - OK TO PAY
PETITION FEE ONLY
Please pay the processing fee at the Student Financial Services Office and return this form to the appropriate office.
NAME: ___________________________________________________ STUDENT ID: _____________________________
Office Use Only
ACCT
FEE
AMOUNT
OFFICE
S2506
Early Grad Verification/Schedule Letter
$10
Graduation Unit - LH-114
S2504
Graduation Update Fee
$10
Graduation Unit - LH-114
S2506
#*Enrollment Verification Fee - Current Term Only
$10
A&R Service Center - LH-114
S2506

#*Enrollment Verification Fee - Prior Terms:
$10
Records Office - LH-114
____Total History, or ____Designated Terms_____________
please specify
S2504
Degree Verification Fee

$10
Records Office - LH-114
S2508
Petition Fee (Retroactive Add, Retroactive Withdrawal, G.E.

$20
A&R Service Center - LH-114
Variation, Reactivate Grad Check, Postgraduate Credit, etc.)
CASH, MONEY ORDER, OR PERSONAL CHECKS
S2508
Replacement Fee

$2
A&R Service Center - LH-114
S2508
Graduate Change of Objective Fee

$10
Records Office - LH-114
S2508
Administrative Late Fee

$20
Graduation Unit - LH-114 (Late Grad Check only)
CASH, MONEY ORDER, OR PERSONAL CHECKS
THIS PRINTED VERSION TO BE USED ONLY FOR PETITION FEE PAYMENT