Sixth College Judicial Affairs Request Form
Note: Please plan accordingly as this request form could take approximately up to 7 - 10 business day turn around before you are notified of its completion.
1) Please complete this form to request a Disciplinary Review of your Student Record and ensure that your information is clearly printed on the Disciplinary Form that you are submitting (i.e. Study Aboard, Dean Certification, etc.) to Sixth College Academic/Student Affairs (i.e. your name, address, and signature of the form(s)).
2) Bring your form(s) to the front desk of Academic/Student Affairs office located on the Second Floor of Pepper Canyon Hall.
3) The Sixth College Academic Affairs and/or Student Affairs staff will fill out the form.
Completed Forms Status:
Study Aboard - Completed forms are directly emailed to Study Aboard Office.
Dean's Certifications/Gov. Agency/Transfer Reports, et al: - Completed forms require a email address for it to be sent, as this is the approved method of delivery/acceptance for both the Universities and/or the Government Agencies.
If you have questions, please contact the Sixth College Assistant to the Dean, Jo-Ann Marie Hoye at 858.822.5953 or
Disciplinary Review Request Form
Please select the type of forms that you are requesting to be completed.
Gov. Agency Background Check
College Transfer Report
Form Completed Notification:
Please note that you will receive a email when this document(s) have been sent via email to the designated email address that you list below.
Please include the email address/es to the Universities and/or Programs requesting this information. This is required in order to have this request of your document successfully processed. There is no limit to the number of emails that you would like to have this information electronically sent.
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This form was created inside of UC San Diego.