MATRICULATION CHECKLISTSteps to Enroll in Classes for New & Returning Students

Page 1 of 3Online Matric Checklist REV. 6/09

Peralta Colleges Admissions & Records Contact Information & LocationsCollege Address Main Phone # A&R Phone # RoomBerkeley City College 2050 Center St. Berkeley, CA 94704 (510) 981-2800 (510) 981-2805 113College of Alameda 555 Atlantic Ave. Alameda, CA 94501 (510) 522-7221 (510) 748-2225 SiteLaney College 900 Fallon St. Oakland, CA 94607 (510) 834-5740 (510) 464-3121 A109Merritt College 12500 Campus Dr. Oakland, CA 94619 (510) 531-4911 (510) 436-2487 P300

Peralta Colleges Assessment Center Contact Information & LocationsCollege Assessment Center Phone # Room Assessment Center HoursBerkeley City College (510) 981-2804 1st Floor M-F 8am-5pmCollege of Alameda (510) 748-2307 L202C M-Th 8am-7pm & Fridays 8am-4:45pmLaney College (510) 464-3259 A102 M-Tu 8am-7pm & W-F 8am-4:30pmMerritt College (510) 436-2566 P102 M-F 8am-4:30pm

Peralta Colleges Counseling Offices Contact Information & LocationsCollege Counseling Phone # Room Counseling Office HoursBerkeley City College (510) 981-2800 1st Floor M-W 8:30am-7pm, Th 8:30am-6pm & Fridays 9am-4pmCollege of Alameda (510) 748-2209 A124 M & Tu 8am-7pm & W-F 8am-4:45pmLaney College (510) 464-3152 T350 M-Tu 8am-7pm & W-F 8am-4:30pmMerritt College (510) 436-2475 P300 M-Tu 8am-7pm & W-F 8am-4:30pm

Peralta Colleges Cashiers Office Contact Information & LocationsCollege Cashiers Phone # Cashier's Office LocationBerkeley City College (510) 981-2142 N/ACollege of Alameda (510) 748-2247 F100Laney College (510) 464-3514 SC 1st FloorMerritt College (510) 436-2438 L104

Peralta Colleges Photo I.D. LocationsCollege Photo I.D. Office LocationBerkeley City College 1st FloorCollege of Alameda F117Laney College SC-410AMerritt College L115

Peralta Colleges Bookstore Contact Information & LocationsCollege Bookstore Phone # Bookstore LocationBerkeley City College (510) 204 0900 or (510) 841-7323 N/ACollege of Alameda (510) 748-2247 F100Laney College (510) 464-3514 SC 1st FloorMerritt College (510) 436-2438 L104

Step 1. Complete an application either online (www.peralta.edu) or in person:

Step 2 & 3. Schedule and complete Assessment & Orientation (scroll down for the required MatriculationChecklist that will need to be signed-off as you complete the matriculation steps below.)

Step 4. Meet with a counselor:

Step 5. Enroll in Classes either online or in person at the Admissions & Records Office.

Step 6. Pay your fees either online or in person. Please make checks payable to”Peralta Colleges” andindicate your social security number on the check. If you are mailing your payment please sendattention the cashier’s office to the appropriate address.

Step 7. Get your Photo I.D.:

Step 8. Purchase Textbooks at the Bookstore:

STEP 2: ATTEND AN ORIENTATION

For the:

Note: Please omit dashes when electronically filling out the Social Security Number (Please Type or Print Clearly).

SOCIAL SECURITY NUMBER:

NAME:

DATE:

Year:SpringFallSummer

MATRICULATION CHECKLIST

Course Department # & Title:

Approved Denied

Approved Denied

FOR COUNSELING USE ONLY:

Page 2 of 3MSS Input:Online Matric Checklist REV. 6/09

Last Name, First Name, Middle Initial

Welcome to the Student Success Program! As a new student, you are required to complete the four steps listed belowBEFORE being allowed to enroll via the Web www.peralta.edu or in person at the Admissions & Records Office.Please get this form signed-off as you complete these steps.

ALAMEDA, BERKELEY, LANEY & MERRITT COLLEGES

Date:

NOTE: If you have completed any college level English or Math courses, you may be exempt from the assessment portion ofthe Student Success Program. Please see a counselor to discuss exemptions listed below.

I REQUEST EXEMPTION FROM: (Check the appropriate number, fill in any blanks, then sign and date.)

STEP 1: COMPLETE AN ASSESSMENT

To be signed by Student Services' Staff when completed.

STEP 3: MEET WITH A COUNSELOR

STEP 2: RETURN THIS FORM WITH ALL REQUIRED SIGNATURES, TO THE CAMPUS ADMISSIONS ANDRECORDS OFFICE

ORIENTATION for the following reason(s):

1. I completed orientation at a Peralta District college within the last three (3) years.2. I completed orientation at a non-Peralta college.

3. Other:College Name:

Student Signature:

ASSESSMENT for the following reason(s):1. ENGLISH - I have successfully completed a COLLEGE LEVEL ENGLISH COMPOSITION COURSE WITH A GRADE OF "C" or higher:

College Name:

2. I have taken the English Assessment at a Peralta District College within the past three (3) years.

College Name:Course Department # & Title:

3. MATH - I have successfully completed a COLLEGE LEVEL MATH COURSE WITH A GRADE OF "C" or higher:

4. I have taken the Math Assessment at a Peralta District College within the past three (3) years.5. I have, within the past three (3) years, taken an assessment that can be used by Peralta staff to determine suitable placement in English and Mathematics.6. Other:

Student Signature:Date:

ORIENTATION WAIVER:

ASSESSMENT WAIVER:

Alameda Berkeley Laney Merritt

Date: Authorized By:

COURSE TITLE DAYS UNITS ROOM PREREQUISITEOK BY COUNSELORHOURS

TOTAL UNITS

FOR COLLEGE USEONLY

ALTERNATE COURSES:

DEPT. /COURSE #

OFFICEUSE

IMPORTANT! WHEN SIGNED BY A COUNSELOR, THIS BECOMES YOUR

INITIAL STUDENT EDUCATIONAL PLAN After the start of the term, meet with a counselor to discuss youreducational objectives and update your Student Educational Plan

CODE

Student's Name:

(i.e. 123456789, No Dashes) Social Security #:

INCORRECT CODING WILLRESULT IN ERRORS

Summer Fall Spring Term of 20

AFRAM 017 African American Studies 8-10 MW 4 D14 L1234 Yes No Initials

Maximum unit load for semester term is 18 units. You must obtain counselorapproval for excess units up to 21 units. The Dean of Student's approval isrequired for 22 to 25 units. (Maximum unit load for Summer session is 10 units.)

Example:

Yes No

Alameda MerrittLaneyBerkeley

FIRST CHOICE COURSES:

Yes No

Yes No

Yes No

Page 3 of 3

Online Matric Checklist REV. 6/09 INITIAL Program Confirmed By: Date:

Yes No

Yes No