Sub-Waiver Form Rev. 7/1/20
MiraCosta College
Petition for Course Substitution/Waiver
STUDENT INSTRUCTIONS:
1
. Use one petition for each course.
2. Complete the following sections:
• Section A – Student Information
• Section B (if petitioning to Substitute a course) or Section C (if petitioning to Waive a course)
• Section D (Supporting Documentation)
3. Attach supporting documentation as appropriate.
4. Obtain signatures from (A) the Department Chairperson for the course being petitioned (names/office locations found online in the MiraCosta College
class schedule at http://www.miracosta.edu/schedules.html); and (B) the Dean of the Department.
5. If petitioning for a DEGREE or CERTIFICATE OF ACHIEVEMENT, submit completed form with appropriate documentation to Admissions &
Records Office on either campus by the deadline listed in the class schedule (http://www.miracosta.edu/schedules.html).
6. If petitioning for a CERTIFICATE OF PROFICIENCY, submit completed form to Daria Davis in Building 4800, Office #4820 or via email at
dariadavis@miracosta.edu
A. Student Information
Name Student ID#
Previous Name(s) used, if any:
Address
Number Street City State Zip
Phone Number:
Email Address
Please check one: I am applying for a(n):
□ Associate Degree □ Bachelors in Biomanufacturing □ Certificate of Achievement □ Certificate of Proficiency
Name of DEGREE or CERTIFICATE: # of Units
Anticipated Semester of Completion for DEGREE or CERTIFICATE (i.e. Fall 2019, Spring 2020):
B. Course Substitution: Requesting replacement of a required course in the degree/certificate with a similar course or courses
I wish to substitute:
College Name Course Name / Number (i.e. ART 101) Course Title # of Qtr/Sem Units
In place of: MiraCosta College
College Name Course Name / Number (i.e. ART 101) Course Title # of Qtr/Sem Units
Provide detailed justification for your petition. Attach additional sheets if necessary.
C. Course Waiver: Requesting elimination of a required course in the degree/certificate without substituting a similar course or courses
I wish to waive the following course:
MiraCosta College Course and Number (i.e. ART 101) Course Title Qtr/Sem Units
Provide detailed justification for your petition. Attach additional sheets if necessary.
D. Supporting Documentation Attached (as appropriate):
□ Transcript(s) □ Catalog Description (non-MiraCosta Course) □ Other □ None of these (n/a)
Department Chair’s Recommendation: □ Approve □ Deny Catalog Year Used for Certificate:
Comments:
Signature: Date:
Dean’s Recommendation: □ Approve □ Deny
Comments:
Signature: Date:
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