Elective Satisfactory/Unsatisfactory Option
Spring 2020 Semester
I request permission to take the following course through the Elective
Satisfactory/Unsatisfactory Option for the Spring 2020 Semester:
Course Title___________________________________________________________________
Course #_______________Class#______________ Credits______________
Instructor Signature____________________________________________________________
Advisor Signature_____________________________________________________________
For requests for major program requirements, the department chair signature is
required. International students and athletes must have applicable signatures for all
requests.
Department Chair of student's major____________________________________________
Director of International Programs______________________________________________
Coach or Athletic Director_____________________________________________________
I have read and understand the Elective Satisfactory/Unsatisfactory Option for the Spring 2020
Semester.
Student Name:______________________________________Emplid #__________________
Student signature:____________________________________Date_____________________
Request must be submitted no later than May 8, 2020
Return complete form containing all required signatures to:
kathleen.meyer@dickinsonstate.edu
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