Request for Time Extension
(To be completed by student’s major advisor)
Date:
Department:
Student ID Number:
Student Name:
College:
Degree:
Semester and Year of Admissions to Program:
Graduation Date Requested for Extension:
Please explain why this student should be allowed a time extension to complete his/her degree.
If the student is in a master’s or specialist’s program, please explain how out-of-date course work will be
recertied to ensure the student’s knowledge of the subject matter is current.
If the student is in a doctoral program, please explain how the student’s knowledge of the eld will be current
at the time the degree is granted.
Program Director Signature:
Advisor Signature:
College Dean Signature:
Attach additional documentation to email if needed.
Registrar Signature:
12/16
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