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Waiver Powered By Docstoc
					                                School of Education

 Petition for Administrative Waiver of Standard Rules and Regulations
    (Please complete and return to the SED Office of Student Records for processing)

Name _________________________________ ID ___________________________________
       Last                     First
Address ______________________________________________________________________

E-mail ________________________________ Phone ________________________________

Expected Graduation Date ________________      Degree Program ________________________

Major ________________________________         Advisor _______________________________

Waiver Requested:

       ______ Request for Leave of Absence beyond the two semesters authorized by
              current regulations (Graduate students only)

       ______ Graduate without certification (undergraduates only)

       ______ Seek exception to departmental/program requirement

       ______ Seek exception to SED Literacy Testing requirement

       ______ Walk in May

       ______ Other __________________________________________________________

Circumstances and reasons for the request: (attach separate sheets if needed)

Student _________________________________ Date _________________________________

(For Records Office use only)

Advisor ________________________________ Date __________________                Approved
               Signature                                                        Not Approved

Chairman ______________________________ Date __________________                 Approved
               Signature                                                        Not Approved

Associate Dean __________________________ Date __________________               Approved
               Signature                                                        Not Approved