REGISTRAR STAFF ONLY
Date Received: _______________
Received By:_________________
Date Processed: ______________
Return to the Office of the University Registrar | IST Room 2052 | 863.874.8540 | registrar@floridapoly.edu
Course Enrollment Permission Request
Please complete all required fields in pen. A Late Add petition must be completed if adding a course after the ADD/DROP
deadline; one form is required per course. Department Chairs are the approving authority for the course subject area.
LAST: _________________________________________ FIRST: ___________________________________ MI: _____
STUDENT ID: __________________________________ EMAIL: _______________________________@floridapoly.edu
STEP 1: Student Must Complete Prior to Signature Approval
I am requesting permission to enroll into the following course for: _______________________________________
TERM/YEAR
Course Title Course Prefix Course Number Course Section Credits
Please select applicable waiver requested and identify course(s):
Co-Requisite Waiver: _______________ Pre-Requisite Waiver: _______________ Catalog/Major Change
Co-req Waived
Pre-req(s) Waived
Independent Study: _____________________ Other: _____________________________________________
Please Specify
Student Signature: ____________________________________________________ DATE: ______________________
STEP 2: Academic Success Coach STEP 2: Academic Success Coach
STEP 2: Department Chair (Please provide explanation before signing.)
I have reviewed this request and it has been: REQUEST DENIED REQUEST APPROVED
Explanation Required: ____________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Department Chair Signature: _________________________________________________ Date: __________________
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