Petition for Change or Substitution
OFFICE OF THE REGISTRAR Student Name:_____________________________________ ID Number:__________________ Major(s):______________________________ Minor(s):________________________________ School in which program change would occur: ________________________________________ Type of Program Change Requested: Waiver Substitution (circle one) Requirement: Proposed Change or Substitution: ____________________________________ ___________________________________ ____________________________________ __________________________________ Justification for Request (to be completed by the student and/or advisor): Additional pages may be attached as needed. _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ __________________________________________________________________________ ________________________________ ____________________________________ Student Signature Date Advisor Signature Date Action approved Action approved Action denied Action denied ____________________________________ ___________________________________ Department Chair Signature Date School Dean Signature Date GENERAL-EDUCATION SUBSTITUTION OR WAIVER Substitutions or waivers in general-education courses must be approved by Deans Council. Action approved Action denied ________________________________________________________ Provost Date NOTE: Form MUST be returned to Office of the Registrar. Rev: 5/02
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