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Resources and Forms
Learning and Academic Resources

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The following request forms are for the LAR Department requests only.  Please complete and submit to the appropriate office by the deadline requested.  Incomplete or illegible forms may be returned to you, and it may delay your requests. 

Please feel free to contact us to assist you with your requests at either of these general numbers for the LAC Multidisciplinary Success Center (L212) (562) 938-4699 or the PCC Multidisciplinary Success Center (EE206) (562) 938-3991.

For more specific assistance, availability, or to submit a request please contact the Centers’ Instructional Lab Coordinators.
Emily Barrera (562) 938-4705
PCC: Elizabeth Gallardo (562) 938-3976


All forms below have been saved using PDF format. 

Adobe PDF Proctoring Make Up Test Form  This is a writable PDF form.
     Download and save to your computer's desktop or a storage device first.  
    Then open and fill out the PDF form and save.  
    Submit request to the department no less than 24 hours before needed.

Adobe PDF Request SI for Your Class 

Adobe PDF Tutoring Referral Form

Adobe PDF  LAR Syllabus Blurb


Your Syllabus

YOU want your students to be successful in your class. WE want to help!  Add this short paragraph to your syllabus and gives students the information they need to get help from day one of the semester.

The Learning and Academic Resources Department offers services and classes designed to help you improve your academic performance.  Free tutoring, study skills assistance, computers, and more are available at both campuses.  For more information visit: or contact the Multidisciplinary Student Success Centers at LAC (L-212, 562-983-4699) or at PCC (EE-206, 562-938-3991).

Word Document Syllabus Statement Downloadable Version