REQUESTFORCHALLENGE,WAIVER,ORVALIDATIONEXAMINATION
(Onecopytobefilledoutforeachexamination)
INSTRUCTIONS:
1. ThestudentmustcompletepartAandsecuresignaturesforpartBofthisform.
2. ThestudentsubmitstheformtotheAssociateVicePresidentforAcademicAdministration.
3. Aftersecuringapprovaloftherequest,thestudentpresentstheformtotheteacher
administeringtheexam.
4. Afterthestudenthastakentheexam,theteacherwillverifythestudent’sexamandsendthe
formtoRecordsandAdvisement.
5. Aftermakingproperentriesonthestudent’stranscript,RecordsandAdvisementwillretainthewhitecopy,sendtheyellowcopy
toStudentFinance,andreturnthepinkcopytothechairoftheexaminingdepartment/school.
CRITERIAFORGRANTINGCREDITFORCHALLENGEEXAMINATIONS:
TheexaminationmustbepassedwithaBorbettergrade.
Agivencoursemaybechallengedbyexaminationonlyonce.
Atleast12hoursmustbeearnedatSouthernbeforecreditisofficiallyrecorded.
Nocoursemaybechallengedafterastudenthasbeenenrolledinitmorethantwoweeks.
Nocoursemaybechallengedaspartofthelast30credithoursofanydegree.
Certaincourses,asdeterminedbythedepartment/schoolfacultymaynotbechallenged.
FeesaslistedinthecurrentSoutherncatalogwillbecharged.
A.APPLICATIONDATA
Name:_______________________________________________ID#:Date:___________________
LocalAddress:
CellPhone:______________________
Email:__________________________________________________________________
HomePhone:____________________
Major(s):__________________________________________________ClassStanding:FRF2SOJRSR
TestType:ChallengeWaiverValidation
CourseCoveredByExamination:
Department Course# CourseTitle #Hours Professor

Reasonyouarequalifiedtotaketheexamination:______________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
B.APPROVALSIGNATURES
InstructorAdministeringExamination:_______________
_
__
_
_________
_
_____________
_
__ Date:____
_
______________
Chair/DeanofExaminingDepartment/School:__
_
_________________
_
__________
_
______ Date:___________________
AssociateVicePresidentforAcademicAdministration:_
_
__
_
__
_
_____________
_____
_
__ Date:___________________
ApprovedDeniedExplanationiftherequestisdenied:____________________________________________________
____________________________________________________________________________________________________________
FOROFFICE USEONLY
VerificationnoticestoRecordsandAdvisementandStudentFinance:
Dateexaminationtaken:______________________________________ InstructorAdministeringExam:_________________________
ExaminationFee:__________________________________(seecatalog) RecordsSignature:_____________________________________
RecordingFee(Challenge/Validation):_______________(seecatalog) RecordsSignature:_____________________________________
COPIES:White—RecordsandAdvisement;Yellow—StudentFinance;Pink—Chair/DeanofExaminingDepartment/School