Effective 20180522
Richard W. Riley College of Education
Winthrop University
PETITION FOR TEACHER EDUCATION PROGRAMS
Purpose: Any student wishing to request an exception to stated program admission requirements, an
internship admission requirement, or a teacher education policy must make such an appeal in accordance
with the policies and procedures established by the Educator Preparation Committee (EPC).
REQUIRED MATERIALS: Please check off the documents you are attaching.
Clear, brief statement of request
Clear, brief rationale for request (include what happens if petition is denied)
Transcript or printout of DegreeWorks
When related to PRAXIS testing, attach a copy of registration and/or past scores.
When related to Internship II, attach a copy of mid-term and final evaluations for Internship I. If
no internship evaluation is available, please attach documentation (e.g., observation record, e-mail
from supervisor, or explanation why not available).
AFTER OBTAINING ADVISOR AND DEPARTMENT CHAIR SIGNATURES,
SUBMIT THIS FORM TO: STUDENT ACADEMIC SERVICES, 144 WITHERS
Student Name
Student Number
Student E-mail
Degree/Major
Current Phone
Expected Grad. Date
Cumulative GPA
Last Semester GPA
Hours Completed
Hours Current Semester
Academic Data Verified by SAS _____________________ (Initial and Date)
Signature of Student _____________________________________________ Date ________________
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Effective 20180522
Richard W. Riley College of Education
Winthrop University
PETITION FOR TEACHER EDUCATION PROGRAMS
To be completed by Advisor: _____ Support _____ Support with Reservations _____ Do Not Support
Rationale (REQUIRED):
Signature of Advisor _____________________________________________ Date ________________
To be completed by Department Chair: _____ Support _____ Support with Reservations _____ Do Not Support
Rationale (REQUIRED):
Signature of Department Chair ________________________________________ Date ________________
Action by Petitions Committee: _____ Support _____ Support with Reservations _____ Do Not Support
Signature of Committee Chair ____________________________________ Date _________________
Action by the Dean: _____ Approved _____ Not Approved _____ Approved with the following conditions:
Signature of the Dean ____________________________________________ Date __________________