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:
_____150 credits (dual degree)
(NOTE: MAXIMUM 2 CREDITS)
3._____ 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)
4._____ 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)
5._____ OTHER REQUEST: Please explain your request on the back side
of this form and tell why you think 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.
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