Fillable Office of Records and Registration Request for a (Adirondack Community College)

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Office of Records and Registration Request for a (Adirondack Community College)

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Office of Records and Registration
640 Bay Road, Queensbury, NY 12804-1445
CALL: 518.743.2279 | FAX: 518.832.7601 | EMAIL: registrar@sunyacc.edu
Request for a Second Degree Exemption Waiver
Students may request a second degree exemption providing:
1. The student has successfully completed one degree or are in their final semester of the 1
st
degree, BEFORE this request for
waiver.
2. The second degree program has a significant amount of additional coursework in a different field of study. The general education
courses from the first degree may be applied to additional degrees.
3. The student will earn a minimum of 84 credit hours, which is required to obtain a second degree.
Completed forms should be submitted to the Student Success Center in Warren Hall.
This exemption, if approved, will not be used toward determining your financial aid eligibility.
General Person Information
Banner ID: _____________________________________
Student Name (Please print): ____________________________________________________________________________
First Middle Last
First Degree: ______________________________________ First Degree Graduation Date: ________________________
Second Degree Requested: ___________________________
Student Success Center Use Only:
Number of required remaining credits listed in the Major section of the Degree Works audit for the 2
nd
degree: ______________
Director of Student Success Recommendation with Justification: ________________________________________________________
___________________________________________________________________________________________________________
Director of Student Success Signature: __________________________________________ Date: _______________________
Academic Affairs Office Use Only:
Decision of Associate Vice President for Academic Affairs:
☐ Approve ☐ Deny
Additional Criteria: ____________________________________________________________________________________________
___________________________________________________________________________________________________________
Associate Vice President for Academic Affairs Signature: _______________________________ Date: _______________________
Registrar Office Use Only: Initials: ______________________ Date Processed: ______________________
☐ Scanned to Financial Aid
☐ Scanned to Student Success
☐ Scanned to Student Updated 7/16/2019
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Office of Records and Registration Request for a (Adirondack Community College)

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Completed 20 September 2020

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