Special Exemption Request Form

Admissions and Records

Dec 23
One Time Holiday - All Campus Offices are Closed

Dec 24
Suspended Operations - All Campus Offices are Closed

Dec 25
Christmas Day Holiday - All Campus Offices are Closed

Dec 26
Suspended Operations - All Campus Offices are Closed

Dec 27
Suspended Operations - All Campus Offices are Closed

Name *

First

Middle

Last

Prior Name(s)

First

Middle

Last

JALC Student ID *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Telephone/Cell Number *

DOB (MM/DD/YYYY) *

Email Address *

Confirm Email

Request

Justification *

You may attach up to three documents to support your justification. Please attach documents as either a Microsoft Word document or an Adobe PDF document. The maximum file size for each document is 10 MB.

Supporting Document(s)

Click or drag files to this area to upload. You can upload up to 3 files.

Verification *

By checking this box, you are signing this document electronically and you verify that the information provided is accurate and true.

This form takes 4-6 weeks to be reviewed. An email will be sent to the student’s Volmail account after a decision has been made.

JALC.EDU

Admissions and Records

Admissions and Records

Upcoming Campus Holidays and Closures

Special Exemption Request Form