CLARK UNIVERSITY
Fifth Course Request Form
BLUE OR BLACK INK PEN ONLY NONERASEABLE
Name:
Date:
Student ID#:
Telephone:
Class Standing:
Email Address:
Permission to enroll in 5.0 units is given only to those juniors and seniors who have attained a
minimum cumulative GPA of 3.0 or a minimum term GPA of 3.0 in the previous semester.
(Sophomores with a minimum cumulative GPA of 3.60 may be considered for special approval.)
I hereby request a fifth course for semester, 20
The reason for this request is:
for personal enrichment
to make up a deficiency
as part of a program of acceleration (Note: students marking this option must have
a formal plan of acceleration approved and on file at Academic Advising.)
Other: (Please specify)
If there are exceptional circumstances which should be considered in your request, please provide
additional information on a separate sheet.
***Please note: this request will be considered only when the grades from the previous/most
recent semester have been received and recorded by the Registrar’s Office.
Upon review of your record, your request for a fifth course has been:
Denied. Student’s academic performance does not warrant the award. A strong
performance with four courses will improve chances next semester.
Denied. Student is not a Junior or Senior; no exceptional circumstances.
Denied. Other
Approved. Student meets the criteria for a fifth course.
Director/Assistant Director, Academic Advising Center