CONCURRENT ENROLLMENT WAIVER REQUEST
School District:_______________________________________________________________________________
Course Name and Number:_____________________________________________________________________
Requestor’s Printed Name:_____________________________________________________________________
Per the Minnesota State College and Universities Procedure 3.5.1 Post-Secondary Enrollment Options (PSEO) Program
Subpart H. PSEO Concurrent Enrollment Exceptions. A high school that wishes to have a college or university offer a PSEO concurrent
enrollment course to its students, but cannot generate sufficient enrollment to offer that course only to 11th and 12th grade students who
meet the PSEO eligibility requirements may request approval.
I am requesting M State consider (check appropriate boxes):
Waiver for 9
th
and 10
th
Grade Students
An exception from the president of the college to allow 9th or 10th grade students who rank in the upper
one-tenth of their class, or attain a score at or above the 90th percentile on a nationally standardized,
norm-referenced test, or have a favorable recommendation from a designated high school official to
enroll in our course. *Please attach a list of (9
th
/10
th
grade) student’s names.
______ Total number of 9
th
and/or 10
th
grade students requesting a waiver for
Waiver for Non-PSEO Students to Enroll
An exception from the president of the college to allow non-PSEO students to enroll in the course.
______ Total number of students I am requesting this waiver for
I certify that: PSEO students will be the MAJORITY of the students in the course; and the concurrent
enrollment instructor and college faculty member will ensure that all PSEO students are held to
college-level course standards.
_______Total number of students taking the course FOR college credit
Additional information/rationale for the college president’s consideration:
Requestor’s Signature___________________________________________ Date__________________
Email completed forms to erin.warren@minnesota.edu.
M State President’s Signature_____________________________________ Date___________________
