Please complete this form when requesting a substitution for UNIV 110. Any course considered must have been completed at a
regionally accredited institution. Approval of this substitution applies only to the individual student. Approval of this substitution
does not waive the PSR2 General Education requirement.
1. Students will submit the form to the Academic Support Center, lower level of the Library.along with course syllabi,
description, and any additional materials (if needed). Please complete all student information required on the form prior to
delivery of substitution request materials.
The FYE Faculty/Staff committee will evaluate materials, determine approval of the substitution, and, if applicable,
complete the course information and rationale(s) and then sign the form.
The FYE Director will review the materials and recommendation of the committee and sign the form, if applicable. If the
substitution is not granted, the student is responsible for completing UNIV 110 as stated under the Minot State University
General Education requirements.
The FYE Director will return the approved substitution form to the Registrar’s Office. The Registrar’s Office will record
the substitution in the student’s Academic Advisement Report.
Student Name _________________________________ Student ID # ________________ Date ______________
Substitution for UNIV 110 requirement only. This substitution will not waive the PSR2 developmental
requirement under the Minot State University General Education requirements.
Transfer Institution:
Transfer Course Information (Course Number/Name/ Description):
Student rationale for substitution:
FYE rationale for decision regarding this substitution:
substitution request was: Approved Denied
for UNIV 110 course:
Signature of FYE Faculty/Staff representing review committee
Signature of FYE Director