Fillable Southern Utah University - Time Conflict Form

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Southern Utah University - Time Conflict Form

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The Southern Utah University - Time Conflict Form form is 1 page long and contains:

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Country of origin: US
File type: PDF

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TimeConflictForm
Office Stamp
STUDENTINFORMATION:
Name: T‐Number:
Last First MI

(orSSNifyoudonotknowyourStudentID#)




StudentSignature
Date


SEMESTER/YEAR:
Term:
Spring Summer Fall
Year:



JUSTIFICATIONFORTIMECONFLICT:
Facultyshouldreviewspecifictimeconflictpriortosigning.
FIRSTCOURSE
Subject_______________CourseNumber_____________Section____________CRN____________
CourseDates____________‐_____________CourseDay(s)________________CourseTimes____________‐____________
Ihavereviewedthetimeconflictandattestthatitwillnotimpactstudentlearning.
Instructor(PrintedName)_________________________________________________________
Instructor(Signature)______________________________________________________________Date________________________
SECONDCOURSE
Subject_______________CourseNumber_____________Section____________CRN____________
CourseDates____________‐_____________CourseDay(s)________________CourseTimes____________‐____________
Ihavereviewedthetimeconflictandattestthatitwillnotimpactstudentlearning.
Instructor(PrintedName)_________________________________________________________
Instructor(Signature)______________________________________________________________Date________________________
Revised03/28/2011
INSTRUCTIONS
:
1. Pleasecompletealloftheinformationbelow
2. Studentmustprovidejusti ficationforhowthetimeconflictwillnotimpact
academicintegrity(formssubmittedwithoutjustificationwillnotbeprocessed).
3. Studentmustget signaturesfromBOTHinstructors.
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Southern Utah University - Time Conflict Form

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Completed 16 April 2020

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