Section 1: Request Type Request Type Request Type - Select - Add student after workshop Assign student to class Change student class Move student level Drop student Waitlist student Late add (class started) Correct enrollment error Other… Enter other… Section 2: Student Information First Name Last Name COM Student ID (if available) Date of Birth Preferred Name Phone Email CCCApply ID (if available) Section 3: Class Request Requested Class: Example: Tue/Thu PM — Level 2 — Canal Day / Time Location (Canal / COM Kentfield/ COM IVC) Level (if known) Section 4: Current Class (If Applicable) Only fill if student is moving: Current Class: Level: Instructor: Section 5: Reason for Request (Required) Reason: Reason: - None - Student attended CA workshop Student requested change Level adjustment Schedule conflict Class full at Canal Instructor recommendation Administrative correction Other… Enter other… Section 6: Urgency Urgency Normal Urgent (class started) Same-day needed Section 7: Submitted By Name Role Role - Select - Canal Alliance Supervisor Canal Alliance Navigator COM Adult Ed Staff COM Instructor Other… Enter other… Submitter email address Section 8: Notes Notes Example: Student tested Level 2. Please add to Tue/Thu PM. Prefers morning classes, etc.