Fillable NIVERSITY OF INNESOTA STUDENT PETITION FOR REQUESTING TO (University of Minnesota - Crookston)

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NIVERSITY OF INNESOTA STUDENT PETITION FOR REQUESTING TO (University of Minnesota - Crookston)

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The University of Minnesota is committed to the policy that all persons shall have equal access to its programs, facilities and employment without regard to
race, color, creed, religion, national origin, sex, age, marital status, disability, public assistance status, veteran status or sexual orientation. This form is
available in alternative formats upon request. Please call Disability Services at 218-281-8587.
U
NIVERSITY OF
M
INNESOTA
Crookston Campus
Office of the Registrar
9 Hill Hall
2900 University Avenue
Crookston, MN 56716-5001
218-281-8547
Fax: 218-281-8549
STUDENT PETITION FOR
REQUESTING TO ENROLL IN A COURSE A THIRD TIME
NOTE
• Students may only repeat a U of M course or its equivalent once.
• Petitions to request to take a course a third time are rarely approved.
• Petitions to take a course a fourth time will not be considered.
• Even though an instructor/advisor may suggest that a student repeat a course for a third time and/or supports the
student’s request, this would not be acceptable grounds for approving a student’s petition.
• You are encouraged to review the petition guidelines for enrolling in a course a third time.
PROCESS
• Complete this petition in detail and secure the signature of your advisor prior to submission.
• The Academic Standards & Policy Committee will review your request, as necessary.
• The decision will be sent to your official University email account.
• Review of a properly completed petition may take five or more business days.
PART 1: Student background
University ID
Name (last, first, middle)
Birth date (mm/dd/yyyy)
@umn.edu
Personal e-mail address
Phone (include area code)
Current mailing address (street, apartment number or P. O. box number, city, state, ZIP Code, country)
PART 2: Course requesting to repeat
List the class(es) you are requesting to repeat.
Term/year
Course subject, number, section
(e.g., Comp 1011-003)
5-digit class
number
Credits
Grade basis
(A-F or S/N)
Instructor Signature
(only if needed)
PART 3: Details on requesting to repeat a course a third time
Explain in detail why you were not successful the first two times you took the class(es)?
The University of Minnesota is committed to the policy that all persons shall have equal access to its programs, facilities and employment without regard to
race, color, creed, religion, national origin, sex, age, marital status, disability, public assistance status, veteran status or sexual orientation. This form is
available in alternative formats upon request. Please call Disability Services at 218-281-8587.
What do you believe has changed that will allow you to have success at this time?
Have you discussed with your advisor possible alternatives (course substitution or taking a similar class at another
college)? What were the details of the alternatives discussed?
STUDENT CERTIFICATION
By signing this form, I am certifying that the information I provided is true. I understand that misrepresentation of facts or
documentation may be sufficient cause, in and of itself, for automatic denial of this appeal and may be in violation of the
Student Conduct Code and subject to disciplinary action up to and including dismissal.
Student’s signature (required)
Date
PART 4: Adviser’s section
Adviser’s Comments/recommendations
Adviser’s signature
Date
PART 5: Action taken
The following action has been determined after University of Minnesota review.
Petition is: □ approved □ denied
Comments
Signature of authorized AS&P committee member/staff
Date
SUBMIT TO: Office of the Registrar, 9 Hill Hall, 2900 University Avenue, Crookston, MN 56716
Email: umcreg@umn.edu
Fax: 218-281-8549
6/22/15
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NIVERSITY OF INNESOTA STUDENT PETITION FOR REQUESTING TO (University of Minnesota - Crookston)

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Completed 24 July 2020

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