Course Repeat Form - River Valley Community College

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Date
MM slash DD slash YYYY
Student Name*
Student ID #*
Email*
Enter Email Confirm Email
Academic Program*
Course Number and Title to be Repeated*

For example: BIOL201R Anatomy & Physiology I
Term you would like to take course again*

For example: fall 2023
Please state the reason why you plan to repeat this course*
Please list the academic activities that you will implement to facilitate your success in the repeated attempt of this course. These activities may include but are not limited to the following: meeting on a regular basis with your faculty, seeking assistance from tutors, working on test taking skills, etc.*
Signature of Student*
Date*
MM slash DD slash YYYY