REQUEST FOR UNDERGRADUATE NON-GEC COURSE SUBSTITUTION
This is a fillable form and must be typed; handwritten forms will not be accepted. Only one substitution per form.
Student Name_________________________________________ EMPLID____________________________ Campus: HBG GP Online
College____________________________________________ School_____________________________________________________________
Degree plan (Major) ______________________________________________________ Minor _________________________________________
Catalog Year_____________________________ Application for graduation: No Yes, Term_____________________________________
COURSES
Required course prefix & number ____________________ Required course title _____________________________________________________
Substitute course prefix & number on DPR __________________ Substitute course title on DPR ________________________________________
JUSTIFICATION (Please check the boxes below that apply.)
Attach to this form a current DPR and documentation, including a Transfer Credit Evaluation Report in the case of a transfer class.
A. This is a transfer course from an accredited institution
Name of transfer institution _________________________________________________
Transfer institution’s course prefix & number __________________ Course Title _________________________________________________
1) The student is a transfer student who took the class prior to enrollment at USM.
Explain how the courses are equivalent in the equivalency box below. Rationale is transfer class taken prior to enrollment at USM.
2) The student is not a transfer student and/or took the class after being enrolled at USM.
Attach the approved Permission to Transfer Credit form; explain both the equivalency and rationale for the substitution in the boxes
below.
B. This is a course taken at USM
Is this a substitution that the school regularly or normally supports? No Yes.
Check a category below and explain both the equivalency and rationale for the substitution in the boxes below.
1) Substitution is requested as a result of required course unavailability. Explain in rationale box below.
Which term & year was the required course last offered? ___________________ When will it be offered next? ___________________
2) Substitution is requested as a result of change of major. Explain in rationale box below.
3) Substitution is requested as a result of misadvisement. Explain in rationale box below.
4) Other. Explain in rationale box below.
PROVIDE EXPLANATION BELOW FOR JUSTIFICATION, INCLUDING BOTH EQUIVALENCY AND RATIONALE
Explain
equivalency
of course to
the required
course.
Explain
rationale for
requesting
substitution.
APPROVALS Substitution request supported
Major Advisor ____________________________________________________ Date _______________________ Yes No
School Director ___________________________________________________ Date _______________________ Yes No
College Dean ____________________________________________________ Date _______________________ Approve Deny
