Fillable Deviation Request Form Registrars Office (State University of New York at Plattsburgh)

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Deviation Request Form Registrars Office (State University of New York at Plattsburgh)

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The Deviation Request Form Registrars Office (State University of New York at Plattsburgh) form is 1 page long and contains:

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U.S.A. forms for State University of New York at Plattsburgh

BROWSE STATE UNIVERSITY OF NEW YORK AT PLATTSBURGH FORMS

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___________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
Deviation Request Form Registrar’s Office
SUNY Plattsburgh
101 Broad St. Kehoe 3
rd
Floor
Plattsburgh, NY 12901
FAX: 518-564-4900
EMAIL:registrar@Plattsburgh.edu
Student’s Name: ______________________________________________________________________________ Date: ______________________
Student’s ID: ___________________________ Major: ___________________________________________ Minor: _________________________
Local Address: ____________________________________________________________ Plattsburgh Email:________________@plattsburgh.edu
City, State, Zip: __________________________________________________________ Telephone: ____________________________________
Class Year: Freshman_____ Sophomore_____ Junior_____ Senior_____ Anticipated Term of Graduation: ____________ __________
Month Year
Major or Minor, for Substitution or Waiver (list course catalog numbers and titles or policy):
Major Minor: Substitute ________________________________________ for _______________________________________________
Waiver : Waive ___________________________________________________________________________________________________
Reason: ___________________________________________________________________________________________________________
General Education, for Substitution (list course catalog number, title and GE requirement):
General Education: Substitute_________________________________________ for GE requirement _______________________________
Reason: ____________________________________________________________________________________________________________
College Policy, for Waiver or Substitution:
College Policy: _______________________________________________________________________________________________________
Waiver Substitution: ____________________________________________________________________________________________
Reason: _________________________________________________________________________________________________________
Course substitution is a:
Plattsburgh Course (completion date): ______________ OR Transfer Course From (name of college): _____________________________
I understand SUNY Plattsburgh’s academic policies. I realize it is my responsibility to verify all information and to satisfy all degree requirements.
Student’s Signature: __________________________________________________________________________ Date: _____________________
Required Signatures:
_____________________________________________________________________
Indicate Approval in Email
Academic Advisor (sign for all deviations)
_____________________________________________________________________
Indicate Approval in Email
Chairperson/Coordinator (sign only for major or minor deviations)
____________________________________________________________________
Indicate Approval in Email
Dean (sign only for major and minor deviations)
Recommended
Recommended
Approved
Not Recommended
Not Recommended
Disapproved
Date:___________
Date: ___________
Date:___________
Required Signature only for General Education and College Policy deviations:
____________________________________________________________________
Indicate Approval in Email
Associate Vice President for Academic Affairs (Provost’s Office, 8
th
Floor Kehoe)
Approved Disapproved Date:___________
Comments:____________________________________________________________________________________________________
Indicate Comments in Email
Allow two weeks for processing.
VPAA-2020
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Deviation Request Form Registrars Office (State University of New York at Plattsburgh)

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Completed 27 August 2020

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