Student Appointment Request Intake Form (CoSS SSC)
This form is for SJSU students in the College of Social Sciences that are returning from taking time off or have been disqualified from the university. The College of Social Sciences Student Success Center (CoSS SSC) is available to meet with students to discuss their path to return to SJSU. 

Disqualified: You are a previous student that has been disqualified from the university. (Under a 2.0 SJSU Cumulative GPA)

Former Student Returning: You are a previous student that is returning after taking more than 2 consecutive semesters off (Above a 2.0 SJSU Cumulative GPA)

An advisor will contact you within 2-3 business days with a confirmation for an appointment. 

The College of Social Sciences Student Success Center
Clark Hall 240
408-924-5363
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Email *
Personal Information
First Name *
Last Name *
Class Level *
Are you a Former Student Returning (FSR)? or a Disqualified Student (DQ)? *
Student ID Number *
Please use 9 digits with leading 0's. If Unknown, put 000000000.
Email Address *
Please use the email you are most responsive to. 
Phone Number *
Appointment Information
Reason *
Appointment Modality *
Day(s) Available *
Required
Time(s) Available *
Required
Academic Details
This section is optional and will help us better prepare to assist you. You can leave it blank if you are unsure.
Your Major While Attending SJSU
Do you plan to apply to a different major than your original one? If so, which one?
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