Student Number
Name (Last, First) Date
From
Class No. Course Name
Course No.
Instructor’s Signature
To
Authorization for Level Change
This form approves a change of class level to move students into a class of an appropriate level.
An Authorization for Level Change must be submitted to the office of Admissions Records & Services prior to an elapse
of 10% of class meetings. An instructor initiating this level change to be approved must get the approval of two additional
instructors.
Course Name
Course No.
Instructor’s Signature
Year:
Fall
Spring
Summer
Class No.
Instructor’s Signature
Instructor’s Signature
Instructor’s Signature
Approval to waive requisite(s):
Please explain the type of measure(s) that were used to assess the student’s proficiency level:
BACK OF FORM
This Form functions both as a section change & an approval for change of level
A Level Change must be submitted by the end of the second week of an 18 week course, or before 10% of a course has elapsed in
the case of a short-term course.
This does NOT load a requisite clearance, it is a one-term waiver of requisite for level changed course
To Complete the Level change you must:
* Administer an assessment sample of the student’s level and it warrants a change of course level.
* Have the assessment sample used be peer reviewed by two additional instructors and have them agree to the level change.
* Find a class for the student to change to, and get the instructor of record’s approval for the class change.
Students that do not successfully complete the level changed course MUST complete the proper requisite subject to {INSERT
REGULATION HERE}
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