Jackson State University
Jackson, Mississippi
AUTHORIZATION TO SUBSTITUTE GRADUATE COURSES
___________________________________________________ _________________________
Name Student J Number
is hereby authorized to substitute
______________ _______________________________________________ _____________
Course Number Course Title Credit Hours
For
______________ _______________________________________________ ______________
Course Number Course Title Credit Hours
The former course was taken ________________________________________
Semester and Year
Reason: _______________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
___________________________________________________ _____________
Student’s Signature Date
Actions:
_______________________________________ ______________ _______ _________
Advisor Signature Date Approve Disapprove
_______________________________________ ______________ ________ __________
Department Chair Signature Date Approve Disapprove
__________________________________________ ________________ _________ ___________
Dean of School Signature Date Approve Disapprove
__________________________________________ ________________ _________ ___________
Dean of Graduate School Date Approve Disapprove
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