Statement of Intent to Register/Policy Acknowledgement Form

Program: Cohort: Start Term:

PLEASE REVIEW THE FOLLOWING POLICIES
Withdrawal Policy: Students are automatically registered for each academic term approximately four weeks prior to the first class
date of the term. Any student who wishes to withdraw must notify their Tseng College Program Manager/Coordinator, in writing via
email from the student’s CSUN email address, no less than 24 hours prior to the first class date of the term. Not attending class,
notifying instructor(s) or the academic department of intent to withdraw, or calling CSUN/The Tseng College to express intent to
withdraw does not constitute a formal withdrawal, does not result in withdrawal, and does not remove the tuition charged for the
term.
Refund Policy: The full tuition for an academic term is only waived or refunded if the Tseng College Program Manager/Coordinator
receives written notification of a student’s intent to withdraw, via email from the student’s CSUN email address, no less than 24
hours prior to the first class date of the term. “Full tuition for an academic term” is the total tuition charged for all courses in which
the student is enrolled for that term, including courses that begin after the first class date of the term. Students requesting to
withdraw less than 24 hours prior to the first class date of the term are responsible for the full tuition charged for that term. If you
reside in the state of Alabama, the state of Indiana, the state of Iowa, the state of Maryland, the state of Minnesota, or the state of
Texas please click the link above for your specific state to review respective policies. f you reside in the state of Oregon, please
contact Admissions, Registration and lient Services at collexl csun edu for specific refund policies
Temporary Disruption of Attendance: If, for compelling reasons, a student finds it necessary to miss a significant number of class
meetings or an entire course, the student must consult with their Tseng College Program Manager/Coordinator as soon as the
student is aware that class meetings or courses will be missed.
Time Limitations: Students are expected to complete the curriculum as outlined in the schedule for the program (and cohort, if
applicable) to which they are offered admission. If extraordinary circumstances require a student in good academic standing to
withdraw, the student may be permitted to reenroll in a future term at the sole discretion of The Tseng College, and pending
approval from the academic department. Cohort students may be required to reenroll in a different cohort, or take courses on the
CSUN campus, at an increased tuition rate. Per University policy, students must complete all coursework required in their program
within seven years from the term of admission.

If you accept this offer of admission, you will be registered for your first term and all subsequent terms. If you choose to withdraw
your acceptance, it is your responsibility to inform your Tseng College Program Manager/Coordinator, via email from your CSUN
email address, as soon as possible.

I ACCEPT this offer of admission. I acknowledge that I have read my Letter of Admission and this Statement of Intent to
Register/Policy Acknowledgement Form. I accept all conditions of admission and The Tseng College policies outlined above.
I DECLINE this offer of admission for the following reason(s):
If no reason is provided, we may contact you to follow up

PRINTED NAME:
SIGNATURE: DATE:

* RETURN THIS FORM WITHIN THE TIME FRAME SPECIFIED IN YOUR LETTER OF ADMISSION*
TO:
VIA EMAIL: OR VIA FAX:

Students requiring classroom accommodations should contact the following office(s) for assistance well in advance of the start of their first
term: For special services to accommodate a physical, perceptual or learning disability, contact the Department of Disability Resources and
Educational Services (DRES) at (818) 677-2684 (voice or TTY) or dres@csun.edu. For more information on DRES, visit www.csun.edu/dres. Students
with hearing impairments who require accommodations such as an interpreting, note-taking, tutoring, real-time captioning, and counseling
services should contact the National Center on Deafness (NCOD) at (818) 677-2054 (voice or TTY) or ncod@csun.edu. For more information on
NCOD, visit www.csun.edu/ncod

California State University, Northridge • The Tseng College of Extended Learning

18111 Nordhoff Street • Northridge • California 91330-8352 • (818) 677-3332 • fax (818) 677-3886 • tseng.csun.edu