Fillable Saint Louis University - Petition To Pursue A Certificate Within A Graduate Program

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Saint Louis University - Petition To Pursue A Certificate Within A Graduate Program

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Saint Louis University Graduate Education
Copies sent to Student Major Field Certificate Director Registrar on_____________________(Date)
Revised 01/18
Petition to Pursue a Certificate within a Graduate Program
INSTRUCTION: This form is only to be used by a Classified Graduate School student at Saint Louis University
desiring to pursue a certificate concurrent with (parallel to) an advanced degree. After completing the first section
of the form, the student must route the petition to the major field for clearance and evaluation, then to the certificate
director for assessment of adequate preparation, and finally to the Dean/Director Designee of the
College/School/Center.
Please print:_______________________________________________________ _______________________
(Last Name) (First Name) (MI) (Banner ID)
Local Address:_______________________________________________________________________________
(Street Address) (City) (State) (Zip Code)
E-mail Address: _____________________________________ Local Phone No._____________________________
I have been unconditionally admitted to seek Master’s Ph.D. degree with a major in: _____________________
_______________________________________ I desire to add to my current degree-program pursuit of the
“parallel” certificate program listed below
_____________________________________________________________________________________________
Date: ______________________ Signed: __________________________________________________________
Recommendation of the Major Field:
(Note: The student and the major field must understand that, although some completed, advanced, academic work
will partially fulfill requirements for both certificate and degree, and some elective credits within the degree
program may be assigned to the certificate, full completion of both sets of requirements may total in credit hours an
amount greater than that required to earn the degree alone.) I recommend approval denial of this petition.
Signed:____________________________________________________ __________________________________
(Major-Field Chairperson/Program Director) (Date)
Comments, if any:______________________________________________________________________________
Recommendation of the Certificate Director:
I recommend approval denial of this petition.
Signed: ________________________________________________________ Date: _________________________
Prerequisite deficiencies, if any: ___________________________________________________________________
Petition is approved denied by Dean/Director/Designee on this date: _________________________________
Remarks/Conditions: ____________________________________________________________________________
_____________________________________________________________________________________________
Signed: __________________________________________________ Title: ______________________________
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Saint Louis University - Petition To Pursue A Certificate Within A Graduate Program

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Completed 14 April 2020

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