Dickinson State University
Request for Special Consideration and/or Waiver
of a Graduation Requirement
I,________________________(EMPL ID)________________hereby request that the following action be taken relative to
meeting the graduation requirements as set forth by Dickinson State University.
1._____ I request that I be granted a waiver of the “minor” requirement for graduation purposes because I
have previously earned a/an
____Bachelor’s Degree
____ Associate Degree
2._____ I request that I be granted a waiver of _____ (# of credits) credits for graduation purposes from
the required minimum of:
_____64 credits (associate degree)
_____128 credits (bachelor degree)
NOTE: MAXIMUM TWO CREDITS – Applicable for 2012-2014 or 2014-2016 catalogs only.
PER SBHE Policy 409, Associate degrees require a minimum of 60 semester credit hours,
bachelor’s degrees require a minimum of 120 semester hours which is the current institutional
requirement per the 2016-2017, 2017– 2018 and 2018-2019 course catalogs.
3._____ I request that I be granted a waiver of _____ (# of credits) credits of the dual degree requirement
for graduation purposes from the required minimum of:
_____160 credits (2012-2014 or 2014-2016 catalogs)
______150 credits (2016-2017 or 2017-2018 catalogs)
NOTE: MAXIMUM 2 CREDITS
4._____ I request that I be granted a waiver of the “32 hours of upper division classes” requirement. I
wish to have _____ (#) credits waived
NOTE: MAXIMUM 2 CREDITS
5._____ I request that I be permitted to remain under the governance of
my initial university catalog while pursuing another:
(A)___MAJOR: ________________________________________
(B)___MINOR: ________________________________________
(C)___DEGREE: ______________________________________
(Specify major, minor, or degree)
6._____ OTHER REQUEST: Please explain your request on the back side of this form as to why it is a
reasonable and justifiable request.
____________________________ ___________ ___Approved / ____Not Approved
Department Chair Date
_____________________________ ___________ ____Approved / ____Not Approved
Director of Academic Records Date
_____________________________ ___________ ____Approved / ____Not Approved
Vice President of Academic Affairs Date
Unofficial copy of student transcript must be attached.
