Revised, 7/2013
Request to Take 17 Credit Hours
Please complete all information and submit to the Dean of Students.
Name: Banner ID: Semester:
Total Hours Completed: Cumulative G.P.A.:
List Courses for this semester: Credit Hours:
Total Credit Hours for semester:
Why do you wish to take 17 credit hours?
Which course(s) would you drop if request is denied?
Action: Granted Denied Other
Comment: ___________________________________________________________________________
Dean of Students’ Signature: _____________________________________________________________
Date: ________________________________________________________________________________