MARQUETTE UNIVERSITY GRADUATE SCHOOL
FIELD PLACEMENT CONTINUATION APPROVAL FORM
A field placement continuation course will keep a student in active status while participating in an off-campus internship or practicum. This form is to be used
to request authorization for the course indicated in Section II. The department must submit this form to the Graduate School after signing their approval. The
Graduate School will register the student for the course. As of the Spring 2016 term permission numbers should no longer be provided for continuation
courses. These courses are zero-credit courses. A course fee of $100 will be charged. This form is due in the Graduate School no later than the last day
of registration for Session 1 in the requested term of enrollment. If you need assistance completing this form, please contact the Graduate School at
414.288.7137.
II. Request for Field Placement:
I request the status indicated below for the term indicated above:
Less than half-time (9977) Half-time (9978) Full-time (9979)
III. Departmental Approval
Adviser Signature:
Section Number:
PLEASE FORWARD COMPLETED FORM TO THE GRADUATE SCHOOL
Dept. Chair or DGS Signature:
My internship is located at:
Revised 10/15
Visa Status:Permanent ResidentU.S. Citizen
Citizenship status:
2019201820172016
Year:
SummerSpring
Fall
Registration is requested for:
Degree:
MUID:
Department:
Name:
I. Student Information
LHT < 12 hours/week HT 12-20 hours/week FT > 20 hours/week
I certify that:
-I am aware of the number of hours per week that this status requires, and I will work that number of hours. If I become unable to work that number
of hours, I will notify my department so that my status can be changed appropriately;
-I have examined my Checkmarq account, I have no holds, and I am eligible to register and;
-Once my department has approved this course, I give them permission to submit this form to the Graduate School so that the Graduate School
may enroll me as indicated above. I have reviewed and am aware of the billing policies of Marquette University
(http://www.marquette.edu/mucentral/bursar/billing_index.shtml).
Student Signature: Date:
I certify that:
-I will monitor the hours that this student is completing towards the enrollment status being assigned to them;
-Should the status change, I will notify the Graduate School immediately;
-I will submit this form directly to the Graduate School, who will enroll the student.
Date:
Date:
