Revalidation of Graduate Course(s) - Form 1
The University of Southern Mississippi
Graduate School
118 College Drive #5024 Hattiesburg MS 39406
This PDF form is fillable. Handwritten copies will not be accepted.
Date:
Date:
Instructor Semester Enrolled
Student ID:
Date:
Course to Revalidate
The student listed below is requesting permission to revalidate a graduate level course (or courses) which was completed outside the specified
time limit (5 years for Masters, 6 years for Specialist, and 8 years for Doctoral).
Student Name (First, Middle, Last):
Degree:
Professor to Revalidate Course #4 above:
Professor to Revalidate Course #3 above:
Professor to Revalidate Course #2 above:
Professor to Revalidate Course #1 above:
Signature of Graduate Director/Coordinator:
Upon obtaining signatures, the student will pay $50.00 per course via the "Pay Fees" link at www.usm.edu/graduate-school
and return the
paid receipt to the Graduate School. The administrating faculty member notifies the Graduate School on the outcome of the exam (via the
Revalidation Verification Form 2), the Graduate School will process the course and grade accordingly.
Signature of Dean of Graduate School:
Course to Revalidate
Course to Revalidate
Course to Revalidate
Semester Enrolled
Semester Enrolled
Semester Enrolled
Instructor
Instructor
Instructor
This form is to be completed by the department.
Emphasis:
