OGS 7/18 page 1 of 5
GRADUATE PETITION
INFORMATION AND INSTRUCTIONS
A student may petition the Graduate Council for a waiver of a University graduate academic regulation or degree requirement. In no
case will a regulation be waived or an exception granted because of ignorance of the regulation or of the assertion that the student was
not informed by the adviser or other authority. Portland State University’s accreditation requires that students’ transcripts be an
accurate reflection of their academic record. The decision of the Graduate Council is final.
Any information disclosed about child abuse or sexual assault/interpersonal violence may be subject to mandatory
reporting requirements, which means that confidentiality cannot be guaranteed. To speak confidentially to a campus
advocate prior to completing this form, please contact the Women’s Resource Center at (503) 725-5672 or the Queer
Resource Center at (503) 725-9742. For more information about campus resources and reporting obligations, please visit
www.pdx.edu/sexual-assault and www.pdx.edu/ogc/mandatory-child-abuse-reporting
.
Please read these instructions carefully - they contain essential information for submitting
a complete petition. Incomplete petitions will not be reviewed by the Graduate Council.
It is the student’s responsibility to:
initiate the petition process;
contact the instructor(s), adviser, and Department Chair/Graduate Program Director to obtain their statements;
submit a complete petition to the Office of Graduate Studies.
Page 2 Student information and statement
Complete the information on the top of page 2. This form is available at www.pdx.edu/ogs/forms and we encourage students to
fill out the form online to ensure legibility. After completing the form online, it must be printed for signature and date.
Provide an explanatory statement in support of your petition request. Include details of the courses involved, including course
name and number, term, and CRN. Present clear and concise information about the factors that prevented University policy from
being followed in this case.
Extenuating circumstances must be documented (please note that documentation is confidentially recycled after the petition has
been decided). Some examples of required documentation are:
Medical documentation: letters from medical providers, hospital or clinic admission and/or discharge papers, etc.
Legal documentation: court papers, police reports, letters from legal professionals, etc.
Work schedules verified by employer or dated job offers
Documentation of birth or death
Fill in your name and PSU ID number on the top of pages 3, 4, and 5; if the form is completed online, this information will be
filled in automatically.
Pages 3 & 4 Instructor / Adviser statements
A petition that deals with a specific course must include a statement from the instructor of that course.
A petition that deals with the student’s general academic program must include a statement from the student’s faculty adviser.
A student’s faculty adviser needs to be aware of all aspects of a student’s progress in the program, so all petitions must be
reviewed and signed by the student’s faculty adviser even if the petition request deals with only one course. (Students not
admitted to a graduate program will not have a faculty adviser; in such cases, page 4 is not required.)
See information on the top of pages 3 and 4 for information about what the instructor and adviser statements must address.
Page 5 Department Chair or Graduate Program Director statement
The petition should be routed to the Department Chair or Graduate Program Director only after all other materials are in place; the
Chair or Director will expect to review these materials before providing their statement.
See information on the top of page 5 for information about what the Department Chair or Graduate Program Director statement
must address.
Submission
A petition must be submitted in one, completed packet, NOT piecemeal.
Petitions should be submitted in paper format to the Office of Graduate Studies, 184 Parkmill.
If necessary, a petition can be submitted electronically to grad@pdx.edu. Electronic petitions must be submitted in one, complete
packet as a single PDF.
Incomplete petitions will not be reviewed by the Graduate Council.
OGS 7/18 page 2 of 5
OGS use only: _________ - _________
GRADUATE PETITION
STUDENT INFORMATION / PETITION REQUEST
read all instructions on page 1 before completing this page
Name _______________________________________________________________ PSU ID# ______________________________
PSU E-mail (print clearly)______________________________________________ Daytime phone ___________________________
Degree _____________________ Major _________________________________________________________________________
If not an admitted graduate student, use the space above to indicate current status: post-bac, quick entry, undergraduate, etc.
State the issue being petitioned and provide an explanatory statement in support of your petition request. Include details of the course
or courses involved, including course name and number, term, and CRN. Present clear and concise information about the factors that
prevented University policy from being followed in this case. Extenuating circumstances must be documented. The decision of the
Graduate Council is final.
I hereby petition the Graduate Council to __________________________________________________________________________
(identify SPECIFIC PSU policy/regulation addressed and action requested)
___________________________________________________________________________________________________________
This statement may be attached on a separate piece of paper.
Signature _______________________________________________________________________ Date ______________________
Graduate Council/Graduate Office Use Only Do NOT Write Below
Action by the Graduate Council / Graduate Office
Approval / Denial _________________________________________________________________________ Date ______________
OGS 7/18 page 3 of 5
GRADUATE PETITION
INSTRUCTOR STATEMENT
Student Name ___________________________________________________________ PSU ID # ___________________________
This statement must confirm attendance or non-attendance in the course, demonstrate knowledge of the situation including possible
extenuating circumstances, and provide the instructor’s recommendation and rationale as to whether University policy should or
should not be waived in this case.
A signed statement may be attached on a separate piece of paper (electronic signatures are not accepted).
An email may be attached in lieu of a signed statement.
I recommend:
Approval / Denial (circle one) __________________________________________________________________________________
Signature
(electronic signatures are not accepted)
Name (printed) __________________________________________________________________ Date ______________________
OGS 7/18 page 4 of 5
GRADUATE PETITION
ADVISER REVIEW AND/OR STATEMENT
(students not admitted to a graduate program will not have a faculty adviser; in such cases, this page is not required)
Student Name ___________________________________________________________ PSU ID # ___________________________
A student’s faculty adviser needs to be aware of all aspects of a student’s progress in the program, so all petitions must be
reviewed and signed by the student’s adviser even if the petition request deals with a course that was not taught by the
adviser. Advisers may choose to provide a statement in such cases, but this is not required.
Advisers must provide a statement for a petition that deals with the student’s general academic program.
The statement must demonstrate knowledge of the situation including possible extenuating circumstances and provide the
adviser’s recommendation and rationale as to whether University policy should or should not be waived in this case.
A signed statement may be attached on a separate piece of paper (electronic signatures are not accepted).
An email may be attached in lieu of a signed statement.
Please see information at the top of this page regarding when an adviser does or does not need to provide a statement.
____ I have reviewed this petition without providing a statement
____ I have reviewed this petition and provided a statement
I recommend:
Approval / Denial (circle one) __________________________________________________________________________________
Signature
(electronic signatures are not accepted)
Name (printed) __________________________________________________________________ Date ______________________
OGS 7/18 page 5 of 5
GRADUATE PETITION
DEPARTMENT CHAIR OR GRADUATE PROGRAM DIRECTOR STATEMENT
Student Name ___________________________________________________________ PSU ID # ___________________________
This statement must provide the department or program’s recommendation and rationale as to whether University policy should or
should not be waived in this case. The statement must also demonstrate knowledge of the situation including possible extenuating
circumstances; this knowledge may be based on the content of student, instructor, and adviser statements.
A signed statement may be attached on a separate piece of paper.
This petition is not complete without a signed statement from the
Department Chair or Graduate Program Director
I recommend:
Approval / Denial (circle one) __________________________________________________________________________________
Signature
(electronic signatures are not accepted)
Name (printed) __________________________________________________________________ Date ______________________