Admissions & Records

Student Services Center, Room 115
2600 Mission Bell Drive
San Pablo, CA 94806
(510) 215-6027
Fax: (510) 412-0769


Click title to access:

Student Data Change Request​Student Consent for Access to Education Records

Applications/Admissions Forms

Application for Admissions to Contra Costa College
Application and Program Bulletin for the Nursing Program – See ‘Nursing’ page
Exemption from Matriculation Form *** See Counseling
High School Concurrent Enrollment Form

Enrollment and Registration Forms:

Enrollment Application
Course Transfer Form
Petition For Course Repetition Form
***Course Conflict Form******Forms are Available at the Division Offices
Unit Overload
Pass/No Pass Request
Late Add Petition 
Reinstate Request Form-Located in A&R
Application for credit by exam
Credit by examination -courses allowed 
*Early Graduation Petition for Early Registration 
*For Students Planning to Graduate or Transfer

Residency Forms:

California Residency Reclassification Request
AB540 Form 

Evaluation Forms:

Prerequisite Verification /Challenge Form
Request for Transcript Evaluation

Veteran Forms:

10 Steps to Success Checklist (PDF)
Statement of Responsibility (PDF)
(Veterans) Educational Plan

-See a VA Counselor to have an Education Plan on File.  Only courses on your Ed Plan may be certified.

VA Education Benefits Certification Request (PDF)

-Required every semester


 Request Forms/Student Services:

Assessment-Clearance Waiver

 Declaration or Change of Major 
Enrollment Certification via InSite Portal Online
Enrollment Certification Request Mail/Fax PDF
IGETC-CSUGE Certification Request w-Transcript 

Student Consent for Access to Ed Records (PDF)

Transcript Request via InSite Portal
Transcript Request Form-Mail/Fax PDF


Note:  CCC will not offer transcript services during Winter Recess.  Please note the following:

Last day to request  RUSH transcript before winter break is 12/15/16

NO EXPRESS transcript requests during the month of January 2017

RUSH transcript processing time is 48 hours during the month of January 2017.

Appeal Forms:

Petition for Academic Renewal
Registration Appointment and BOG Appeal (due to probation/dismissal or are over 100 units) 

Degree/Certificate Forms:

Petition for Degree/Certificate 
Diploma-Certificate Replacement