SCHEDULE EXCEPTION FORM
Office of the Registrar-University of Central Arkansas
ID #: Contact Phone #
TERM YEAR
Last Name First Name MI
Course Information
CRN Course Prefix Course Number Instructor
Course Instructor Signature
Print Instructor Name
Date
Course Dept. Chair Signature
Print Dept. Chair Name
Date
Dean of College Signature
Print Dean of College Name
Date
Advisor Signature
Print Advisor Name
Date
I request an exception to register or add classes for the above specified term. I understand that any late
entry into a class at this time may impact on my academic achievement and the number of allowed class
absences.
Student Signature Date
Bring completed form to Registrar Office window counter. Harrin Hall Suite 224.
INCOMPLETE FORMS CAN NOT BE PROCESSED.
OFFICE ONLY:
Processed by: Date:
Total Hours
Before
After
02152016
Registrar Process Date
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