Admissions & Records Forms


Click title to access:

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 Information Packet– Summer 2015

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
Concurrent Enrollment Form (Special Admissions)
*Early Graduation Petition for Early Registration – See Below
*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:

***VA Request for Verification Worksheet (Required every semester)***

Steps to Success – Checklist

Vets Statement of Responsibility** See a VA Counselor to have an Education Plan on File.  Only courses on your Ed Plan may be certified.


 Request Forms/Student Services:

Student Data Change Request
 Declaration or Change of Major Form
Enrollment Certification via InSite Portal Online
Enrollment Certification Request Mail/Fax PDF
Transcript Request via InSite Portal
Transcript Request Form-Mail/Fax PDF

Appeal Forms:

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

Degree/Certificate Forms:

Petition for Degree/Certificate 
Diploma-Certificate Replacement

Admissions & Records

Student Services Center, Room 115

2600 Mission Bell Drive
San Pablo, CA 94806
(510) 215-6027
Fax: (510) 412-0769

***Starting on October 17th the Admissions office will be open from 8am – 12noon for the duration of the semester.

*** October 17th – December 22nd

Day Open Close
Monday 8:00am 4:30pm
Tuesday 8:00am 4:30pm
Wednesday 8:00am 4:30pm
1st Wednesday of the Month 8:00am 6:00pm
Thursday 8:00am 4:30pm
Friday 8:00am 12:00pm


1st Wednesday of the Month:

​Wednesday, August 20th, 2014 – First Wednesday of the Fall 2014 Term

Wednesday, September 3rd, 2014

Wednesday, October 8th, 2014

Wednesday, November 5th, 2014

Wednesday, December 3rd, 2014


The office will be closed for the following college holidays:
Veterans Day – November 10th, 2014
Thanksgiving – November 27th & 28th, 2014
Winter Recess – December 23rd to December 31st, 2014
Winter Recess – January 1st to 2nd, 2015
Dr. M.L. King, Jr. – January 19th, 2015
Abraham Lincoln Day – February 13th, 2015
George Washington – February 16th, 2015
Memorial Day – May 25th, 2015