PART-TIME STATUS. Total Units

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1 PART-TIME STATUS Application for (semester) (year) Major Are you a resident of California? Yes No REASON FOR PART-TIME STATUS: Employment (complete Part 2.A) Family responsibilities (complete Part 2.B) Health/physical disability (complete Form B) Other (attach a full, documented explanation) ATTACH PERSONAL STATEMENT: Include detailed information about your financial circumstances and an explanation why paying full fees would cause you personal and financial hardship. PROPOSED STUDY LIST: Course Course STUDENT'S CERTIFICATION: Units Units Total Units I certify that the information provided in conjunction with this application is a true statement of my circumstances that necessitate part-time study. MAJOR ADVISER'S ENDORSEMENT: Approval is Recommended Not Recommended Comments: DEAN'S ENDORSEMENT: Application is Approved Denied Comments:

2 APPLICATION FOR PART-TIME STATUS PART 2 A. EMPLOYMENT DATA & CERTIFICATION Employer/firm Job title/description Hours of employment per week Job Status: Permanent SUPERVISOR'S ENDORSEMENT: Temporary until The preceding data concerning the above named employee are certified to be correct information as of this date. B. FAMILY RESPONSIBILITIES Spouse s name Spouse s occupation List of other members of household (attach copies of birth certificates for children under 18): Age Relationship Description of applicant's responsibilities to the family: of applicant

3 APPLICATION FOR PART-TIME STATUS FORM B: MEDICAL LIMITATIONS Physician s name Medical specialty See instructions below regarding required letter from your physician. Student's description of the limitations on activities normally required of full-time students: Duration: permanent temporary until Student s signature Note to student: It is your responsibility to authorize your physician to provide certification of the medical necessity for a reduced study load and to discuss with your physician the amount and nature of the medical details that you wish disclosed as justification of your need for enrolling in a reduced study load. Approval of this application depends upon the dean's determination that there exist genuine limitations upon the student's abilities to engage in a typical academic program of study. Note to physician: Please provide on your official letterhead, sealed in an envelope, certification of the above student's medical necessity to limit enrollment in the University of California to a level substantially less than what is required of a full-time student. Give your sealed letter to the student to submit with this application. All letters received from physicians concerning the medical conditions of students are considered strictly confidential and their contents are not divulged to anyone outside the College of Letters and Science Dean's Office except as may be required by law.

4 1. Definition of Part-Time Status POLICIES ON PART-TIME STUDY AND REDUCED STUDY LISTS FOR FULL-TIME STUDENTS For Undergraduates Enrolled in The College of Letters and Science PART-TIME STUDY The University authorizes an exceptional category of part-time status for students who have been admitted to the University in accordance with standard procedures but who are unable to attend the University full-time because of compelling reasons of occupation, family responsibility, or health. Part-Time status carries the following conditions: a. Part-time students pay one half of the Tuition paid by full-time students or (if applicable) one half of both the Tuition and the Non-Resident Supplemental Tuition paid by non-resident students. They pay the full Student Services Fee paid by all students. b. Part-time students are strictly prohibited from enrolling in more than two courses at any time during the term. Attempting to enroll in more than two courses, either at the time of the initial enrollment, or by adding courses during the term, will necessitate the payment of full fees and will result in the denial of part-time status for subsequent enrollment. Application for Part-Time status must be made in writing to the Dean of the College PRIOR TO THE START OF INSTRUCTION EACH SEMESTER. Procedures for applying for Part-Time status are set forth below. Part-Time status is considered an exceptional case, to be accorded only for compelling reasons of personal hardship that preclude full-time attendance, and to be specifically arranged in advance of each term. It does not include full-time students who must work part-time or otherwise full-time students who happen to have academic justification for enrolling in a reduced number of units. In particular, University policy explicitly states that "Parttime status may not under any circumstances be accorded to students not otherwise eligible for such status whose approved study list, for whatever reason, is permitted to fall below minimum limits: such students must continue in full-time status." 2. Eligibility for Part-Time Status in Letters and Science To be eligible for Part-Time status as an undergraduate in the College of Letters and Science, one of the following conditions must be met. a. Occupation: Full-time, regular career employment of at least 35 hours per week. Documentary evidence must be presented that part-time work, or other work arrangement permitting a full course-load, is not possible. Self-employment does not qualify, unless evidence can be provided that leads to a strong presumption that regular work of at least 35 hours per week will be required throughout the duration of the term in question. The same is true for employment in a family business belonging to a relative of the student. b. Family Responsibility: 1) Single parent with infants or pre-school children 2) Managerial responsibilities for a family whose size and age distribution impose a workload equivalent to regular employment of 35 hours per week. Documentary evidence must be presented that alternative child-care arrangements cannot be made. c. Health: Permanent, or semi-permanent medical conditions or physical disabilities that either prevent or render detrimental to the student's health sustained activity at the level required for full-time student status.

5 3. Application for Part-Time Status in Letters and Science a. Procedures: Application forms are available from the Office of Undergraduate Advising, College of Letters and Science, 206 Evans Hall. They may also be downloaded from the OUA website: <lsadvise.berkeley.edu>. The forms must be completed and submitted to the Dean with the required documentation and, for students who have declared a major, the endorsement from the major adviser or department chairperson before the first day of classes for which Part-Time status is desired. Submission of applications at least two weeks before the start of the term is highly recommended because allowances should be made for the possibility of being asked to schedule an interview with the dean or being required to submit additional documentation. For students who have declared a major, approval from the undergraduate major adviser will be granted only if 1) the enrollment of part-time students does not jeopardize or otherwise limit enrollment of full-time students in the department's program, and 2) the proposed study list makes maximum progress towards completion of requirements given the limited number of units involved. Separate applications must be made for each regular semester of the University for which Part-Time status is desired. b. Personal statement: The personal statement needs to include detailed information about the student s financial circumstances and an explanation regarding why it would be a personal and financial hardship for the student to pay full fees. c. Documentation: The requisite documentation varies with the conditions for which Part-Time status is requested. The principal information requested for each category is indicated on the application form. Employment: In the case of regular employment by an unrelated employer, completion of Part 2.A of the application, including the requested certification by the work supervisor, will normally constitute sufficient documentation. Family Responsibilities: Minimal documentation includes completion of Part 2.B of the application, and presentation of birth certificates for all children listed in Part 2.B. An interview with the dean may be required. Health or Physical Disability: Required documentation includes completion of Form B accompanying the application and a separate letter of certification from the student's physician. Attention of both student and physician are directed to the notes on Form B. In all cases, approval of an application for Part-Time status depends upon a decanal judgment that sufficient justification exists for the granting of Part-Time status. Additional documentation may be required on the basis of the circumstances of each particular case.

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