COLLEGE IN THE HIGH SCHOOL
PETITION FOR AN EXCEPTION TO AN ADMINISTRATIVE POLICY
Office of the Registrar
University of Minnesota, Crookston
This petition is used by the student and the CIHS Facilitator to request an exception to University of Minnesota Crookston campus policies.
Contact the UMC Center for Adult Learning before submitting this petition to discuss the ramifications of this request and to explore other
options such as requesting an Incomplete grade. Petitions are usually acted upon within one week, but processing delays may occur due to
the availability of faculty and staff. DO NOT ASSUME APPROVAL OF YOUR REQUEST UNTIL YOU ARE NOTIFIED BY E-MAIL.
Please complete all information requested fully and completely. A decision on this matter may alter the student’s
official UMC academic record. This form will be returned if the request is unclear, information is incomplete, or
appropriate documentation is not included.
PLEASE INCLUDE A CURRENT HIGH SCHOOL TRANSCRIPT.
Student Name (last, first, middle)
UMC Student ID # or Last 4-digits of SSN
Student Mailing Address (street, city, state, zip code)
Name & Title of CIHS Facilitator and High School Name
CIHS Facilitator
E-mail Address
CIHS Facilitator
Telephone Number
You will be notified of the decision by e-mail.
[ ] CANCEL under terms of UMC’s “one-time” drop policy
[ ] CANCEL-Didn’t meet CIHS eligibility of 3.00 high school GPA
[ ] CANCEL-Didn’t meet CIHS eligibility of Junior standing
[ ] CANCEL-Didn’t meet CIHS eligibility of 2.00 UMC GPA
[ ] High school registration error
[ ] Center for Adult Learning registration error
[ ] Student registration error
[ ] Student canceled HS course but not UMC course
[ ] Credit overload due to year-long courses
[ ] OTHER. State clearly your specific request. Attach a separate
sheet if more space is needed:
II. Explain the circumstances that led to this appeal and why the University should approve your request. Attach a separate sheet if more space is needed.
III. Course Add/Cancel. Complete this section ONLY if your request involves adding or canceling a class
[ ] YES [ ] NO I certify that the information provided is true. I understand that misrepresentation of facts
in connection with this form, whenever discovered, may be sufficient cause, in and of itself, for rescission of any related
decision and the initiation of a disciplinary complaint.
CIHS FACILITATOR SIGNATURE
SUBMIT TO:
Office of the Registrar, University of Minnesota, Crookston, 9 Hill Hall, 2900 University Ave., Crookston, MN 56716-5001
Fax: 218-281-8549 Email: umcreg@umn.edu
(2/10/14)
