Course Waiver Request
Check only one of the following:
• Summer
• Fall
• Winter
Year:
Note: This form must be returned to the office of Registrarial Services
A. General Information
Note: Information in this section must be completed in full.
ID Number:
Last Name:
First Name:
B. Course Information
Course: (e.g. SOAN)
Code: (e.g. 4250)
Section: (e.g. 0104)
Course Title: (e.g. Energy and Society)
Instructor’s Acknowledgement
Based on our discussions I, the instructor undersigned, acknowledge that the student may not have the specified
requirements. By way of my signature I am waiving them.
Course Prerequisite or Corequisite Waiver
A prerequisite is a requirement for entry into a course. A corequisite is a course, the content of which is integrated with that
of another course such that the courses must be taken simultaneously. Signing this box will override the prerequisite or
corequisite requirement.
Course Restriction Waiver
A rule that restricts access to the course based on Student Program or previous credits. Signing this box will override this
rule.
Instructor Consent
Instructor’s Signature:
Date:
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signature
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