_________________________________ ________________
Student's Name: _____________________________________
Student ID Number: __________________________________
Class Item Number: __________ Course ID: ____________
Class/Program: ______________________________________
Class/Program Start Date: _____________ Start Time:_______
(Check all that applies)
Class is full -- OK to overload this student
Student may admit/register for this course
Variable Credit Student will enroll for ________ Credits
Student is re-entering
Student may audit this course
Waive course/program pre-requisites
Instructor Name: _____________________________________
(please print)
Instructor's Signature Date
Submit this form to Enrollment Services office, Bldg. 17.
This approval expires 5 business days from date of signature.
For Enrollment Services office use only
Fall ________ Processed by:
Winter ______
Spring ______ _______________________________________
Summer _____ Date
Rev. 9/9/14
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