INSTRUCTIONS TO STUDENT *
A. After discussion of your plan with your
Advisor, secure the approval of (1) your
Program Advisor; (2) the department or
Division Chairman; and (3) the
appropriate Dean(s).
B. Pay the fee at the Cashier’s Office, Room
217, Welcome Center. This fee is subject
to change at any time by action of the
Board of Governors.
C. Present the receipted form to the
Examiner and take the examination.
INSTRUCTIONS TO EXAMINER *
A. After the examination results have been
determined, indicate the student’s grade.
B. Retain a copy for your records.
C. Mail a copy to Student Records, 5057
Woodward, 5
th
Floor. DO NOT
TRANSMIT VIA STUDENT.
*NOTE: To receive credit by examination, a
student must have enrolled for one semester
and completed at least one course. Also,
credit by examination cannot be used to
repeat a course.
854 (04/20)
Wayne State University
STUDENT RECORDS (Please read instructions)
Student Name (Last First) I.D. Number Date
Undergraduate Graduate
TO THE EXAMINER:
Do not administer the examination(s) unless
stamp appears in box at right.
FEES ASSESED
_______ Hrs. @ $10.00 Per Credit Hr. = $__________________
CERTIFICATION OF RESULTS OF EXAMINATION
Signature of Examiner Date
PETITION FOR CREDIT BY EXAMINATION
THE EXAMINER RETAINS THE THIRD COPY
(2) Department Chairperson's Approval
(3) Dean or Representative's Approval for College in
which course is taught
College in which student is registered
HAS PERMISSION TO TAKE SPECIAL EXAMINATIONS COVERING:
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