COP 202 Exemption Form to Waive Program Requirement
Eligibility: To waive COP202, relevant full-time or equivalent part-time work experience in your major field of
study within the last 3 to 5 years, must be demonstrated. Upon verification of the information
provided below, you will be notified by mail as to the approval/disapproval of this request.
Directions: Submit completed form with any attachments to: Kristen Kaeding, NSCC, Career and Technical
Education and Business Division, Room DB-314, One Ferncroft Road, Danvers, MA 01923.
Part 1 - STUDENT INFORMATION:
Student Name: ___________________________________________ Student ID #: N00______________
Student Address: _____________________________________________________________________________
Address City State Zip
North Shore Email: ___________@northshore.edu
Telephone: (Home) ______________________________________ (Cell) ___________________________
NSCC Major: Accounting
1
Graphic Design
2
Marketing
1
(choose one) Culinary Arts & Food Service
2
Legal Admin Asst
2
Medical Admin Asst
2
Executive Admin Asst
2
Management
1
Hospitality and Tourism
2
1
If waiver is approved, students must substitute a 3-credit ACC, BUS, MKT, MGT elective.
2
If waiver is approved, students must substitute a 3-credit open elective.
Directions: Part 2 should be completed for each separate employer. Resume may also be attached. Student
should sign and date as indicated.
Part 2 EMPLOYMENT INFORMATION: (Employers will be contacted by department/program chairs for verification.)
Company Name: ___________________________________________ Co Telephone Number: __________________
Company Address: ________________________________________________________________________________
Address City State Zip
Name & Title of Supervisor: _________________________________________________________________________
Supervisor Email Address: __________________________________________________________________________
Dates Employed: Full-time: _____________________ Average Number of Hours per Week__________________
Part-time: _____________________ Average Number of Hours per Week __________________
Job Title: ________________________________________________________________________________________
Brief Job Description: (Explain how this job relates to your NSCC program major. List duties, responsibilities and any special
skills you may have; include all software used.)
Student: _________________________________________________ Date: ____________________________
(Signature)
Typed name is acceptable if emailed from your North Shore email.
Office Use Only:
APPROVED:
NOT APPROVED (reason):
Department Chair: ________________________________________ Date: ____________________________
(Signature)
Distribution:
Original to Student
Student Enrollment/Records
Program Coordinator/Department Chair
Coop Ed Coordinator