Undergraduate Arranged Course Request

Student ID Number        Date  

Student's Name
        may take an arranged course
Last                                  First                                   Middle/Maiden

with me in     for credit hours for the
                  Course                             Course Number

semester

________________________________                                                                 _________________
        Signature of Instructor                                                                                          Date

________________________________                                                                 _________________
  Signature of Department Chairman                                                                          Date      

________________________________                                                                 _________________
     Signature of Dean of School                                                                                   Date

 

Please return this request to the Office of Registration and Records, Parsons Hall Room 009, along with a completed Scheduling Form. Registration in the class will be completed at this time.