Request for Graduate Credit Registration for
Senior Undergraduate Students
Undergraduates within nine credits of graduation with a minimum cumulative grade-point average (GPA) of 3.0 are eligible
to apply to enroll and earn graduate-level credit. Please see requirements and directions on the back of this form.
Clarion ID: Date:
Name:
(Last) (First) (Middle) (Former)
Home Address:
(Number and Street) (City) (State) (Zip Code)
Local Phone:
Undergraduate Major: Total Hours Earned:
(*Including all transferred credits, current
credits, & credit by exam)
Cumulative GPA:
I am requesting permission to take graduate level coursework for the semester or Summer
(Term/Year) (Year)
Course No. Section No. Course Title Credits
Total credit to be granted:
(Graduate)
Student's Signature: Date:
Approved: Date:
Date:
Date:
Approved:
Approved:
Approved: Date:
(Undergraduate Advisor's Signature)
(Department Chair of Undergraduate Major)
(Graduate Program Coordinator)
(Student's Dean Signature)
Requirements and Directions
Request for Graduate Credit Registration for Senior Undergraduate Students
This application form is intended for senior undergraduate students at Clarion University who are within nine credits of
graduation, including current courses in progress. Students must have a cumulative GPA of 3.0. Students who are
interested in this option are advised to meet with their undergraduate academic advisor and the appropriate academic
graduate program coordinator prior to completing this form. Information is also available from the Office of the Registrar.
Graduate areas of study reserve the right to limit student enrollment in graduate-level programs. Some graduate-level
courses may have prerequisites and/or course expectations that prohibit the enrollment of undergraduate students.
Students should speak with the appropriate academic graduate program coordinator for information regarding eligibility
to enroll in a specific graduate course.
Credits earned under this program establish a permanent graduate-level record at Clarion University and are available for
transfer to other accredited institutions. Credits earned under the program are for graduate credit, separate from the
undergraduate credits earned for degree, and will not be calculated in the student's undergraduate credit and grade-point
total. Questions should be directed to the Office of the Registrar or the student's undergraduate advisor.
Please review the directions and requirements listed below:
1. File the Request for Graduate Credit Registration Form during the registration period for the intended semester.
(The form is good for only one semester at a time; therefore, students are not automatically eligible to register for
graduate credit the following semester.)
2. Courses to be taken must be identified on the application form before signatures and final approval. No substitutes
are permitted.
3. Students may not take more than two graduate-level courses per semester. A limit of nine graduate credits may be
earned prior to formal admission as a graduate student.
4. This form requires the signatures of the undergraduate advisor, department chair, graduate program coordinator,
and the dean of the undergraduate program. Completed forms are to be returned to Becht Lobby Resource Desk.
5. Graduate credits earned may be transferred to another institution at the option of the receiving school.
6. Tuition and fees: undergraduate students taking graduate courses will be charged undergraduate tuition and fees
for all courses.
7. Financial Aid: contact Student Financial Services at 1-800-672-7171, opt. #2 to determine if taking graduate
coursework will impact your financial aid eligibility.
8. Return the completed, signed form to Becht Lobby Resource Desk.
Clarion University is an affirmative action equal opportunity employer. 1/14
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