PETITION FOR PHYSICAL EDUCATION CREDIT BASED ON MILITARY EXPERIENCE
Name: ___________________________________________________________________________________
SS#: _____________________________________________________________________________________
Date of Birth: _____________________________________________________________________________
Beginning Date of Military Service: ____________________________________________________________
Discharge Date: ____________________________________________________________________________
A copy of your DD-214 indication honorable discharge must be attached to this request in order to award three
hours of physical education credit for your military experience.
Approved
Credit Denied
_________________________________________ Less than one year service
Student Signature Other than honorable discharge/separation
*Return form to Registrar’s Office __________________________________________
Registrar