10/9/2013
OFFICE OF THE REGISTRAR
MSC 105, 1050 W SANTA GERTRUDIS AVE
KINGSVILLE, TEXAS 78363-8202
PH (361) 593-2811 * FAX (361) 593-2195
www.tamuk.edu
(Please print)
Name: ___________________________________________________ ID #: __________________________
(Last) (First)
Phone #: __________________________________ Email: ______________________________________
Are you GRADUATING this semester? ____ Yes _____ No
Are you on SCHOLASTIC PROBATION or ENFORCED WITHDRAWAL? ____ Yes _____ No
Have you requested a transcript to be sent after grade change? ____ Yes _____ No
Student’s Signature: _______________________________________ Date: _________________________
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REQUEST FOR ADJUSTMENT OF REPEATED COURSES
FORM
For Registrar’s Office use only:
Processed By: __________________________________ Date Completed: _______________________
Completed form can be submitted to: Javelina Enrollment Services Center located in the Memorial Student
Union Building (room 132); faxed to the Registrar’s Office at 361-593-2195; or scanned and emailed as an
attachment to registrar@tamuk.edu. If you have questions, please contact the Registrar’s Office at 361-593-
2811.
