Fillable REQUEST TO RETAKE A COURSE (Forgiveness Policy) (Florida Institute of Technology)

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REQUEST TO RETAKE A COURSE (Forgiveness Policy) (Florida Institute of Technology)

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REQUEST TO RETAKE A COURSE (Forgiveness Policy)
Students must complete this form for courses retaken under the Forgiveness Policy. A course may be forgiven if the student’s initial attempt of the course resulted in an
earned grade of D or F. This form is a BINDING AGREEMENT between the student and Florida Tech and cannot be withdrawn once submitted. To be applied, this form is
due in the registrar’s oce no later than Friday of the 12th week of classes for fall or spring semester, Friday of the third week before the end of regular classes for a
summer term, and no later than Friday of the fth week of classes for Florida Tech Online students. Once applied to a repeated course, forgiveness cannot be reversed.
Forgiveness Policy is not applicable to graduate courses/students.
NAME _______________________________________________________________________________________ DATE __________________________________________________________
Last First
STUDENT ID NO. __________________________________________ MAJOR CODE ______________________ LOCAL PHONE NO. ______________________________________________
Student Signature ____________________________________________________________________________________  Date ___________________________________________________
RGR-468-0220
REGISTRAR’S USE ONLY
Processed by _________________________________________________________________________________________  Date _________________________________________________
I REQUEST APPROVAL TO RETAKE THE FOLLOWING COURSE
__________________  ______  __________   ______    ______________________________________________________________________________________
OriginalCRN Prex CourseNo. Section CourseTitle
FOR WHICH I WAS PREVIOUSLY REGISTERED DURING __________________ / ___________ AND RECEIVED A LETTER GRADE OF ________________
Term Year
Please check one: ¨ I plan to (re)take ¨ I have (re)taken during _________________/ _____________
Term Year
__________________  ______  __________   ______    ______________________________________________________________________________________
NewCRN Prex CourseNo. Section CourseTitle
APPROVED: Signatures must be axed in the order they appear on this form, beginning with the academic advisor and academic unit head.
1) Academic Advisor Signature _______________________________________________________________________ Date ___________________________________________________
PrintName ___________________________________________________________________________________________
2) Academic Unit Head Signature* _____________________________________________________________________ Date ___________________________________________________
PrintName ___________________________________________________________________________________________
*AcademicUnitHeadmustapprovetheretakingofacourseforthesecondorsubsequenttime.
REQUIREMENTS FOR APPLYING THE FORGIVENESS POLICY (Form will not be processed without proper signatures axed)
Florida Institute of Technology § Oce of the Registrar § 150 West University Boulevard, Melbourne, FL 32901-6975 § 321-674-8115 § Fax 321-674-7827
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REQUEST TO RETAKE A COURSE (Forgiveness Policy) (Florida Institute of Technology)

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Completed 29 January 2021

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