Financial & Registration Services
Prerequisite Waiver/Permission of Instructor
Submit completed form to Financial & Registration Services, 2
nd
Floor, Clark Hall, Email to: finreg@brandonu.ca
270 18
th
Street, Brandon MB, Canada R7A 6A9 204.728.9520 BrandonU.ca (04/20)
To register in a course for which you have not met the required prerequisite(s), you must obtain written permission from the instructor. Complete the
top portion of this form, select option for approval and submit to the course instructor. The instructor must then initial your selection and there must be
three signatures at the bottom portion of this form. If the waiver request has been approved, it will be forwarded to Financial & Registration Services and
will serve as your registration for that course. You will not be required to submit an additional registration form. You will be able to view the course using the
online student information system once processed. If the waiver request is denied, the form will be returned to you. If you have any questions
regarding your registration contact Financial & Registration Services.
Student Information:
L
ast Name: ____________________________________________ First Name(s): _______________________________________
S
tudent Number: _______________________________________ Degree: ____________________________________________
A
ddress/Box #: ________________________________________ BU email address: ____________________________________
Ci
ty/Postal Code: _______________________________________ Phone Number: ______________________________________
Course Information: Academic Year __________ Regular Session Spring Session Summer Session
NOTE: This waiver, if approved, is valid only for the session indicated above.
TERM COURSE TITLE
Requesting: (check one only) Instructor’s Initials
W
aiver of Prerequisite Course(s) _____
OR
Written Permission of Instructor (required for above course as per General Calendar) _____
OR
Other (please indicate) ____________________________________________________ _____
T
ransfer Courses Pending (for Student Services advisor use only) Advisor’s Initials: _____
Date: ____________________________ Student’s Signature: _____________________________________________________
This form will be processed as a registration form/change of registration form. In signing above, the student acknowledges having read and understood
the ways in which personal information is collected and used at Brandon University, as described at Personal Information Collection/Disclosures
.
Instructor’s Information: Indicate if you approve the above student’s request by initialing beside the selected option and signing below.
If another option is required, please initial beside approved option. This will confirm that the student has your permission to register in
the aforementioned course without prior completion of required prerequisite(s) or has required written permission. This approval may
not be conditional or rescinded once signed by Chair & Dean and processed by Financial & Registration Services.
If not approved, please check here: Denied
Comments: _____________________________________________________________________________________________________
_______________________________________________________________________________________________________________
___________________ / ___________________ _____________________________ _____________________________
(Instructor’s name/signature) (Chair’s signature) (Dean’s signature)
click to sign
signature
click to edit
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