10/17
PETITION OF WAIVER OF GRADUATE ADMISSION POLICY
Please fill this form and return it to the Graduate Office.
Student Name________________________________________________ Graduate Program________________________
Semester of admission_________________________ Undergraduate Program__________________________________
Mailing Address___________________________________________________________________________________________
Address City ST Zip
Email Address_____________________________________________________________________________________________
I am asking that the following Graduate Admission Policy be waived:
Specify admission requirement(s) to be waived: ________________________________________________________________
_________________________________________________________________________________________________________
Reason for requesting waiver (please be specific):_______________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
Student Signature Date Submitted
Student: If more space is needed, attach the necessary sheets. Once the first page is complete, including the signatures at the
bottom, please return the entire form to the Office of Graduate Studies for processing. Your petition will go before the Graduate
Committee at the next scheduled meeting after your completed petition is received. You will be notified via email when your petition
will be presented to the Graduate Committee for consideration.
I have reviewed the file and approve do not approve the waiver of the above admission criteria for the Graduate
program.
Department Chair Date
I have reviewed the file and approve do not approve the waiver of the above admission criteria for the Graduate
program.
Dean Date
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10/17
The Graduate Committee has reviewed the file and approves does not approve the waiver of the above admission
criteria for the Graduate program.
Graduate Committee Chair Date
I have reviewed the waiver of the above admission criteria for the Graduate program.
_____________________________________________________________________
Director of Graduate Studies
______________________
Date