Office of the Registrar
300 The Fenway, Boston, MA 02115
Tel 617.521.2111 Fax 617-521.3144
Major/Minor Requirement: Exemption Approval
Student Name: ________________________________________Simmons I.D: ______________________
E-mail Address: ____________________________Phone Number:________________________________
Students are required to complete all major and/or minor requirements listed in the course catalog for
their declared area of study. If a student cannot complete a requirement, they may seek approval from their
department for alternative arrangements. Only with approval from the department chairperson may the
student be exempt from certain requirements, complete alternative courses for the program, and be
allowed to graduate from their intended major and or minor.
Terms of Exemption
Major(s) Impacted: _________________________________________________________________________
Minor(s) Impacted:_________________________________________________________________________
Anticipated Graduation Date: ________/________
Month Year
Required Course
Alternative Fulfillment
Student’s Signature: _________________________________________ Date: _____________________
Adviser’s Signature: _________________________________________ Date: _____________________
Department Chair Signature: _________________________________ Date: _____________________
Date Received:______________ Initial: _____________
SPRO Comment:
[Date]: [Student Name] is exempt from completing [Required Course] requirement as per the department
through alternative fulfillment with [Alternate Course]. [Initial]
Processed by S. Hurd:___________ Date:________________
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