Special Exemption Request Form

Admissions and Records

April 2025

Friday April 18

Good Friday Holiday-No Classes

May 2025

Monday May 26

Memorial Day Holiday-No Classes

June 2025

Thursday June 19

Juneteenth Holiday-No Classes

July 2025

Thursday July 3

4th of July-No Classes

September 2025

Monday September 1

Labor Day Holiday-No Classes

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.