3050 Martin Luther King, Jr. Drive Phone: (318) 670-9315
Shreveport, Louisiana 71107 FAX: (318) 670-6338
www.susla.edu registraroffice@susla.edu
Policy Governing Academic Amnesty
Any student who has not been enrolled at a college or university for three consecutive years may elect only once to deny all
work attempted at a college or university prior to the three year period; and if you transfer, it may or may not be accepted
by other institutions of higher learning. The three year period does not need to immediately precede the exercise of the
option. The forgiven academic record will appear on the student’s permanent record but will not be used in computing the
student’s grade point average. The only exceptions are to determine honors for graduation and eligibility for financial aid
and/or scholarships. Academic Amnesty is final and irreversible.
The student must be officially enrolled at the University before applying for academic amnesty. The student must apply for
academic amnesty or forgiveness of credit courses in the Office of Academic Affairs within one calendar year from the first
date of enrollment or readmission. The declaration must be completed prior to the deadline for resigning from the University
in the semester in which it is made. A decision to declare academic amnesty is final and irreversible.
For enrolled students who plan to matriculate into professional academic degree programs (i. e. allied health, nursing) at
SUSLA, an exception of the 3 year requirement (only) may be waived with the appropriate approvals from the
Program Director, Division Dean, and the Vice Chancellor for Academic Affairs. All other requirements to declare
academic amnesty cannot be waived.
Date of Request: Readmission Term: Fall Spring Summer Year:
Name:
SUSLA ID#
Last First Middle
Address:
Street Address City State Zip
Phone: ( ) SUSLA Skymail (Email): @susla.skymail.edu
Major: Degree: AAS ___ AGS ___ AS ___ CTS ___ CAS ___ TD ___
Division:
I acknowledge that I have not been enrolled at any college or university during the past three years. After
consultation with my acaemic advisor, I am submitting this form, with a copy of my transcript, to declare
academic amnesty for all
work attempted at a college or university prior to the three year period. With my signature
I accept full responsibility for the consequences of this academic amnesty request, and all other aspects of the
Southern University at Shreveport (SUSLA) academic amnesty policy as stated in the SUSLA catalog.
Student’s Signature: Date:
Advisor’s Signature: Date:
Program Director’s Signature: Date:
Academic Dean’s Signature: Date:
Vice Chancellor’s Signature: Date:
Office of Academic Affairs
Academic Amnesty Declaration
Allied Health and Nursing
Business, Math, Science and Technology
Arts, Humanities, Social Sciences and Education
Denied
Denied
Denied
Denied
Registrar’s Office Use Only
ASA: Academic Amnesty – Revised 07/15:07/16:07/17:08/19LR
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