GRADUATE AND INTERNATIONAL STUDENT SERVICES
UNIVERSITY OF CENTRAL MISSOURI
PETITION FOR DUAL ENROLLMENT FOR SENIORS
Date:____________________
Name: ___________________________________________ Student Number:_________________________
Address: _________________________________________________________________________________
Phone: ______________________ E-mail: ______________________________________________
Request for Coursework in: Fall Spring Summer Year: 20____ GPA:______
□ Submit an application and $30 application fee to the Graduate and International Student Services, please indicate
the semester you will be a graduate student (not the semester you plan to dual enroll).
□ Apply for graduation (UG degree) prior to Registrar approval.
□ Contact Student Financial Services (Ward Edwards 1100, sfs@ucmo.edu
, or 660.543.8266) to determine how dual
enrollment will affect your funding.
I am a senior at UCM. I expect to complete my bachelor’s degree with a major in
________________________________________, at the end of the ____________ (semester). I hereby apply to
take ___________ semester hours of undergraduate coursework and __________semester hours of graduate
coursework as a dually enrolled senior.
The maximum load for dually-enrolled seniors is:
16 hours in fall/spring semester and
9 hours in the summer semester with no more than 6 hours in any one summer session.
My undergraduate schedule will be as follows:
Dept prefix & course #
Course Title
CRN
Semester Hrs.
Session
My graduate schedule will be as follows:
Dept prefix & course #
Course Title
CRN
Semester Hrs.
Session
_________________________________________ __________________
Student Signature Date
REGISTRAR APPROVAL: (Ward Edwards 1000)
_________________________________________
Approved Denied ___________________
UCM Registrar Date
The student understands that if the baccalaureate degree is not obtained during the semester for which approval is
granted, the graduate courses taken will revert to undergraduate credit.
_________________________________________
Approved Denied __________________
Graduate Advisor or Department Chair Date
__________________________________________
Approved Denied __________________
GISS Director Date
Modified on 09/03/2019
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