MARQUETTE UNIVERSITY GRADUATE SCHOOL
GRAD 6945: MEDICAL COLLEGE OF WISCONSIN
Last Name:
Degree:Program:
MUID: Day Phone:
Student Signature: Date:
First Name:
GRADUATE SCHOOL PLANS
MCW Department:
Title of MCW Course:
Course #: Section #:
Year:
Term:
Fall Spring Summer
Signature of Adviser or DGS:
Graduate School Approval:
Date:
Reason for
taking course
at MCW:
Credit Hour:
Revised 02/16
Course Start Date: Course End Date:
NOTE: By signing this form you agree that you have read and understand all program requirements, which are available
online at http://www.marquette.edu/grad/future_MUtoMCW.shtml. Depending on the academic calendar of the institution
where the course is taken, you should be aware that if you take a course at MCW during your final term, your graduation
may need to be delayed.
FOR GRADUATE SCHOOL USE
Transcript Check
Date
Scanned to OTR and returned to Assistant Dean.
Initials: Date:
If you need any assistance completing this form, please contact the Graduate School at 414-288-7137.
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