Academic Advisement Student Exception Request Form

Date

Year/Month/Day

Requester

Department

Phone

Your E-Mail Address

Student Name

Student ID

Academic Plan

(PLEASE SELECT ONE OR MORE OF THE FOLLOWING)

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Course-to-Course Substitution

Substitute Ex.: MATH 223

For MATH 190

Requirement Group #:

Requirement #

Line #

What Requirement should this course fulfill?

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Student Waiver

Waive (Name, Line#, RQ#, RG#)

Reason Ex. Waive Computer Literacy GenEd Req - LN 70, R 21, RG 22 Ex. Reason - Student has extensive computer knowledge

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Exclude a Course from a Requirement

Exclude Ex.: MATH 109

from

RG# Ex.: RG# 238

RQ# Ex.: RQ# 30

LN# Ex.: LN# 10

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Include/Direct a Course to a Requirement

Include Ex.: CIS 205

RG# Ex. RG# 17

RQ# Ex.: RQ# 30

LN# Ex.: LN# 10

Reason: Ex.: Reason - CIS 205 Legacy System Programming meets 3 units of requirements for CIS Depth I per John Doe.

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Requirement Change

Change

RG# Ex.: RG# 238

RQ# Ex.: RQ# 30

LN# Ex.: LN# 10

from from 121

units

to to 125

units

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Other Comments

Registrar's Office

Academic Advisement Student Exception Request Form