Chadron State College
APPLICATION FOR ACADEMIC AMNESTY
Name ____________________________________________ Student ID Number __________________
Last First Middle
Current Address ________________________________________________________________________
Telephone Number ________________________________________
Semester to be in Amnesty __________________________________
Advisor’s Name __________________________________________
Only returning students can apply for Academic Amnesty. Application must be made following the
posting of grades in the term for which amnesty is sought. You must apply no later than the 90
th
calendar day of the subsequent Fall or Spring semester of enrollment.
PROCEDURE:
1. Discuss your desire to apply for amnesty with your academic advisor and the Financial Aid Office.
2. Return the completed application form to the Registrar’s Office.
3. You will receive written notification of the Institution’s decision.
PLEASE NOTE:
1. Term of enrollment includes fall and spring semesters only.
2. Academic amnesty will affect previously granted financial aid. Some loans and grants must be repaid in
full.
3. All courses taken during the semester of amnesty are bankrupt (credit hours and grades). They will
remain evident on your permanent record but will not be figured into your GPA and cannot be used to
meet any degree requirements.
4. Amnesty can be granted only once and is irreversible.
I hereby certify that I have discussed this with my advisor and the Financial Aid Office and that I understand the
conditions and possible repercussions of Academic Amnesty.
Student Signature ________________________________________ Date _______________________
Advisor Signature ________________________________________
RECOMMENDED ACTION
Financial Aid Approval ______Yes _____ No Registrar’s Approval _____ Yes _____ No
03/03
