Jefferson College of Health Sciences

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JCHS Registrar's Office and Forms
Transcript Request Form
Information Release Form (Please use the Transcript Request Form above for all transcript requests)
Registration Form
Add/Drop Form
Change of Major Request Form
Independent Study Contract Form
Name/Address Change Form
Application for Graduation
Student Exit Form
Diploma Replacement Request Form
Request for Administrative Withdrawal
Registration Override Request Form for the Registrar's Office
Documentation to Take Course Work at Other Institution
Letter of Recommendation Authorization Form
Report Request Form
Declaration of a Minor Form
Second Degree Application Form
Dual Major Application Form


Related Pages
Commencement Information


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JCHS Registrar's Office and Forms

Overview
What Happens in The Registrar’s Office?
Welcome to the Registrar’s Office! Our purpose is to serve students from the beginning of their academic careers at JCHS to graduation and beyond.

Our office collects, records and preserves timely and accurate student data regarding registration, enrollment, grades, credits earned or transferred, academic progress and degrees earned, and we ensure adherence to academic policy. 
 
Our staff welcomes your questions, comments and suggestions and invites you to seek us out when you need help.
 
Some of the reasons you may wish to contact the Registrar include obtaining “How To” information on the following processes:
  • Applying for Graduation
  • Calculating GPA
  • Changing a Major
  • Declaring a Minor
  • Declaring a Second Major
  • Finding your Student ID #
  • Learning about FERPA (Family Educational Rights and Privacy Act)
  • Participating in the Graduation Ceremony
  • Registering for Classes, Adding/Dropping Deadlines
  • Replacing a Diploma
  • Requesting Official Transcripts
  • Reviewing Transfer Credits
  • Verifying Enrollment
  • Verifying Good Student Status for Insurance Discounts
  • Searching for Course Offerings
  • Submitting Student Loan Deferment Forms
  • Withdrawing from Classes
Please contact us if we can be of assistance. Contact information for the Registrar's Office is listed below. We look forward to your success here at the college!


Contact Information
Registrar's Office Jefferson College of Health Sciences 
4th Floor, Carilion Roanoke Community Hospital
101 Elm Avenue, SE
Roanoke, VA 24013
Phone: (540) 224-4492
FAX: (540) 224-4562
E-mail: registrar@jchs.edu  
Hours: 8 a.m. to 4:30 p.m., Monday - Friday

  • Linda C. Williams, Registrar
  • Marlene Perrott, Assistant Registrar
  • Lanai Hartman, Department Secretary


Frequently Used Forms

Transcript Request Form

Please use this form to request your official JCHS transcripts from the Registrar's office. Please allow 3-5 business days for your transcripts to be mailed or picked up.

Transcript Request Form (.doc)
Information Release Form (Please use the Transcript Request Form above for all transcript requests)

Any student wishing to have his academic or financial information released to any third parties must sign a Student Permission to Release Information form available in the Registrar's Office or below. The completed form must be submitted to the Registrar's Office.

Student Permission to Release Information Form (.doc)
Student Permission to Release Information Form (.pdf)
Registration Form

To register for classes, you must meet with your academic advisor and complete the Registration Form. These forms are available from the Registrar's Office, from the advisor, or download one below.

Registration Worksheet
Add/Drop Form

Dropping or adding courses must be completed in accordance with the designated time periods as published in the Academic Calendar. An official Add/Drop Form must be signed by the student and by the student's academic advisor. Forms are available in the Registrar's Office.

Request for Administrative Withdrawal (.pdf)
Change of Major Request Form

Currently enrolled students who are requesting a change of major must first submit the Change of Major Request Form to the department they are exiting. After the exiting Program Director signs the form, the student must submit it to the Program Director of the desired program of entry. The student's file will be reviewed in a timely manner and a decision letter will be mailed to the student.  Forms are available from department secretaries or can be downloaded here.

Change of Major Form (.pdf)
Change of Major Form (.doc)
Independent Study Contract Form

Independent Study courses may be offered by certain departments to permit the student to independently investigate specific courses or areas of interest. The Independent Study Course Contract Form is available in the Registrar's office or from this site and must be signed by the student, instructor, the program director, and by the Dean of Academic and Student Services. Formal approval for any independent study course must be granted by the end of the "Add" period of the semester in which the course is taken.

Independent Study Form (.pdf)
Independent Study Form (.doc)
Name/Address Change Form

Currently enrolled students and alumni should remember to update the college with all name/address/phone number changes. Such changes should be submitted to the Registrar on the Address Change Form available through that department or below.

Personal Information Changes Form (.pdf)
Personal Information Changes Form (.doc)
Application for Graduation

It is the student's responsibility to submit an Application for Graduation two academic sessions prior to the session in which the student expects to complete curriculum and college requirements for graduation. A copy of the form is available in the Registrar's Office or can be downloaded from this site.

Application for Graduation (.doc)
Student Exit Form

The Student Exit Form verifies that the student has met all academic requirements and financial obligations to the college before graduation. The form can be downloaded here or can be found in the Registrar's Office. Beginning two weeks prior to Commencement, any senior planning to graduate must submit a completed Student Exit Form to the Registrar after obtaining all required signatures as listed on the form. The deadline to submit the form to the Registrar is the last official day of classes prior to graduation.

Student Exit Form (.doc)
Student Exit Form (.pdf)
Diploma Replacement Request Form

A replacement diploma may be ordered by submitting the Diploma Replacement Form to the Registrar’s Office. The form is available from the Registrar’s Office or can be downloaded from this site.  The charge is $60.00 payable to Jefferson College of Health Sciences is due upon ordering.   The turn-around time is approximately 6-8 weeks. 

Diploma Replacement Form (.pdf)
Diploma Replacement Form (.doc)
Request for Administrative Withdrawal

Students wishing to withdraw from a class after the final withdrawal date (the last date to withdraw with a "W") must complete a request for administrative withdrawal, which is only authorized by the Dean for Academic Affairs for extenuating circumstances.

 

Tuition is not reimbursed with an administrative withdrawal. Students are encouraged to consult the Bursar’s Office (540-985-3585) and the Office of Financial Aid (540-985-8267) to determine the financial implications of their withdrawal.

 

The student must submit a request for administrative withdrawal in writing to the Dean for Academic Affairs. The request must be placed on the official form available below. The form must be supplemented by additional documentation.

The request must:

  • identify circumstances beyond the student's control that have occurred after the final drop date (date must be specified) and prevent successful completion of the course. If such circumstances occurred prior to the final drop date, the request must also document the extenuating circumstances leading to a failure to drop the course before the final drop date. Lack of awareness of the final drop date is not considered an extenuating circumstance.
  • include documentation verifying all extenuating circumstances. Examples of acceptable documentation include a letter from a physician, lawyer, counselor, or other professional.
  • indicate the last day of class attendance or online activity in a distance course.
  • be accompanied by a letter/e-mail from instructors of all courses involved in the request indicating their recommendation regarding the request.

The Dean will respond within five business days of receipt of the student's letter and written recommendation from all involved instructors. A written copy of this decision will be sent to the student with copies to the registrar, course instructors and advisor. The decision of the Dean is final.

Request for Administrative Withdrawal (.pdf)
Registration Override Request Form for the Registrar's Office
  1. An override request from a student should first be reviewed by the student advisor.
  2. If the advisor believes the request is warranted he should complete and sign this request form then submit it to the program director for approval and signature.
  3. The form containing both advisor's and program director's signatures should be submitted to the registrar to process.
Registration Override Request Form for the Registrar's Office (.doc)
Documentation to Take Course Work at Other Institution

Click on the link below to download a form in Word documenting course work that you intend to take at another institution.

Documentation to Take Course Work at Other Institution Form
Letter of Recommendation Authorization Form

Click on the link below to download a Letter of recommendation Authorization Form in Word.

Letter of Recommendation Authorization Form (.doc)
Report Request Form

Click on the link below to download a Report Request Form in Excel.

Report Request Process and Form (.doc)
Declaration of a Minor Form

Click here to download the Declaration of a Minor Form (Word document).

Declaration of a Minor Form (.doc)
Second Degree Application Form

Click here to download the Second Degree Application Form (Word document).

Second Degree Application Form (Word)
Dual Major Application Form

Click here to download the Dual Major Application Form (Word document).

Dual Major Application Form (Word)



Jefferson College of
   Health Sciences
101 Elm Ave., SE
Roanoke, VA 24013
webmaster@jchs.edu
1-888-985-8483

© 2013 Jefferson College of Health Sciences. All Rights Reserved.

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