__________
__________________________ ______________________
Bursar’s Staff Printed Name
Bursar’s Staff Signature
Chair/Director Recommendation:_________________________________________________
______________________________________________________________________________
_______________________________________________________________________________
Name: ______________________________________________________________#: _________________________
(Please PRINT) Last First MI (Include A00 above)
NU Box/Mailing: _____________________________________________ Semester/Year of action: ______________
Phone: (___) ____-______ Major and Minor: _____________________________ Email: _______________________
Check the box for the specific action you are requesting:
Extend Incomplete deadlines
Late
Add (subj #)
Late Withdrawal (subj #)
Total credits after change___________
Exceed Credit Limit on
Probation Transfer
Credit Exceptions
Gen-Ed Substitution
Participation in Extra-Curricular
Activities on probation
Miscellaneous:
Student’s Signature:____
_________________________________________________ Date: _______________
P
Advisor Recommendation:_____________________________________________________
_______________________________________________________________________
____________________________ ____________________________ ____________
Advisor Name (Please Print) Advisor Signature Date
Instructor Recommendation: _____________________________________________________
________________________________________________________________________
____________________________ ____________________________ ____________
Instructor Name (Please Print) Instructor Signature Date
____________________________
Chair Name (
Please Print)
____________________ ____________
Chair Signature Date
Approve
Deny
Date
CASD Chair: ___________________________________________________________________
________________________________________________________________________
____________________________ ____________________________ ____________
CASD Chair Name (Please Print) CASD Chair Name Signature Date
Approve
Deny
Approve
Deny
Approve
Deny
Conditional
Approval
Approve
Deny
PART I: Student and Requested Information
Part III: Decision
Approve
Deny
Petition processed by_______________________
Date_________________
Academic Petition Form
(SEE DIRECTIONS ON REVERSE SIDE)
Part II: Recommendations
Bursar Clearance (only for LATE ADD)
Dean Decision/Recommendation: _______________________________________________________
_____________________________________________________________________________________
Dean Name (Please Print)
Dean Signature Date
______
__________ ___________________________ ________________
RGS: CASD P
etition
Revised 07/2019
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Decision by Dean
SIGNATURES REQUIRED
Late Add
Student, Advisor, Course Instructor, Bursar, Department Chair offering course and
College Dean of the Course
Late Withdrawal
Student,
Advisor, Course Instructor, Department Chair offering course and College
Dean of the Course
General E
ducation or BA
Requirement
Waiver/Substitution
Student, Student Advisor, Course Instructor, Course Chair/Director and Student’s Major
College Dean
Extension for Incomplete
Student, Student Advisor and Course Instructor
Participate in Extra-Curricular
Activities while on Probation
Student and Student Advisor. Separately the Coach/Activity Advisor and the Academic
Achievement Center (AAC) Advisor must write a recommendation letter
Transfer Credit Exception
Student, Student Advisor, Course Chair/Director and Student’s Major Chair/Director
Miscellaneous
Student, Student Advisor, Student’s Major Chair/Director and Student’s Major College
Dean
Exceed Credit Limit on Probation
Student, Student Advisor, AAC Advisor, Student’s Major Chair/Director and Student’s
Major College Dean
RGS: CASD Petition Revised 07/2019
Academic Petition
Form Instructions
Directions
1. Pick up a Petition Form from the Registrar’s Office, or print via www.norwich.edu/academics/registrar.
2. Complete Part I of the form, including checking the box for the desired action.
a. Attach a typed letter documenting the action you are requesting. Provide a clear explanation as to why the
University should take an action that falls outside academic policies & regulations or normal procedures. Include
as much detail as possible regarding your request. Note CRN’s, course subject, number, and section.
b. Attach supporting documentation (medical statements, supporting letters, etc.) as needed.
c. Sign and date your letter and all other attachments.
3. Meet with the approving entities (see chart above) to secure required signatures and recommendations.
Do not expect any of the above individuals to immediately sign your petition.
Some may request that you leave the petition with them for review.
***THE PETITION WILL NOT BE ACCEPTED IF the form AND letter are not signed by ALL individuals who must sign the
petition as listed above.***
For Late Add or Late Withdrawal petitions submitted within 1 month of the Add/Drop or W deadline, or Extension of
Incomplete Deadline, the decision will be issued by the College Dean of the course. Administrative Assistant of the College will
process the petition and notify the student, the advisor, and the instructor about the decision within 2 business days after the
petition is submitted.
In all other instances, the petitions are reviewed by the Committee on Academic Standing and Degrees (CASD) that meets
weekly on Thursday. A Late Add or Late Withdrawal request must be received by the student's advisor in advance of the first
day of final exams. Only requests regarding current term courses will be considered. The petitions must be submitted to the
Registrar Office by NOON on Wednesday in order to be considered at weekly CASD meetings.
The Registrar Office will process the petition and notify the student and the advisor about the decision within 2 business days
after the decision is made.
Petition Appeal Process
If you do not agree with the decision of the College Dean or CASD, you may appeal to the office of the Provost. To appeal,
send an email to provost@norwich.edu requesting the appeal. Your appeal should have an explanation as to why you believe
that the Dean or CASD made a mistake. The decision by the Provost is final.
Decision by CASD
SIGNATURES REQUIRED