Procedures for Petitioning for Course Substitutions and/or Waivers
Procedures for Petitioning for Course Substitutions and/or Waivers
Procedures for Petitioning for Course Substitutions and/or Waivers
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SS-040Print clearly all in<strong>f<strong>or</strong></strong>mationSIS ID _________________________________Petition <strong>f<strong>or</strong></strong> <strong>Course</strong> Substitution <strong>or</strong> WaiverDate: _____________________Name ____________________________________________________________________________________________Last First MiddleAddress ___________________________________________________________________________________________No./Street City State Zip CodePhone Day (_____) ________________ Evening (_____) _________________ Catalog Year __________________Area CodeArea CodeExpected Graduation Date _______________________________VCCS Email _______________________________A) The requested exception applies to the following degree(s)/maj<strong>or</strong>(s):[ ] Associate of Arts –maj<strong>or</strong>/specialization ___________________________________________[ ] Associate of Science –maj<strong>or</strong>/specialization_________________________________________[ ] Associate of Applied Arts – maj<strong>or</strong>/ specialization ___________________________________[ ] Associate of Applied Science – maj<strong>or</strong>/ specialization _________________________________[ ] Certificate Program – maj<strong>or</strong> <strong>or</strong> concentration ______________________________________B) A SUBSTITUTION is requested <strong>f<strong>or</strong></strong> the following course(s) <strong>or</strong> requirement(s):(Attach copy of student advising transcript <strong>and</strong> required documentation <strong>f<strong>or</strong></strong> requested substitution(s).Substitute this course:<strong>f<strong>or</strong></strong> the following requirement:(Prefix, number, title) Credits (Prefix, number, title) CreditsDean's Use OnlyApproveDenyC) A WAIVER is requested <strong>f<strong>or</strong></strong> the following course <strong>or</strong> requirement:<strong>Course</strong>/Requirement:__________________________________________(Attach rationale <strong>and</strong> required documentation.)Dean's Use OnlyApprove Denyq qStudent Signature ____________________________________________________ Date _________________Counsel<strong>or</strong>/Faculty Advis<strong>or</strong> __________________________/_________________________________ Date___________(Please print name)(Signature)Comments _________________________________________________________________________________________________________________________________________________________________________________________Return all copies of this <strong>f<strong>or</strong></strong>m to the appropriate Dean <strong>f<strong>or</strong></strong> the program checked in Section A.____________________________________________Academic Dean Signature________________________________DatePlease <strong>f<strong>or</strong></strong>ward to the Office of Central Rec<strong>or</strong>ds. Do Not Write Below This LineDistribution Copies: Central Rec<strong>or</strong>ds (2) Counsel<strong>or</strong>/Faculty Advis<strong>or</strong>y Division Office Student03/07
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