Office of the Registrar / 200 West Kawili St. Hilo, HI 96720-4091 / Student Services Center, First Floor Rm 101 / Phone: (808) 932-7447 / Fax: (808) 932-7448 / E-mail: uhhro@hawaii.edu
• This form must be completed prior to registration.
• A student may register from one to three credits for any single “496” course.
• Not more than six credits received from “496” courses may be applied toward a degree.
• Students may not use "496” courses to satisfy General Education area requirements.
• The student must obtain the consent (as directed by signatures on this form) of the directing instructor as well as the Department Chair.
• The ORIGINAL FORM must be submitted to the UH Hilo Office of the Registrar for processing of registration.
• All registration deadlines apply for submission and processing of this request.
SECTION I: Student Information:
Name: Student ID:
Last First MI
Phone: Email: @hawaii.edu
Student signature: Date:
SECTION II: Course Information:
Course Alpha:
Course Number: 496
Semester: Fall Spring Summer Year: 20 Credits:
SECTION III: Course Outline:
Description of Course Content and Means of Evaluation (use reserve side or attach a separate sheet):
SECTION IV: Directing Instructor and Department Chair permission:
Directing Instructor’s name:
ID or username:
Directing Instructor’s signature:
Date:
Department Chair’s name:
Department Chair’s signature:
Date:
SECTION V: Submit ORIGINAL completed form to the Office of the Registrar.
FOR OFFICE USE ONLY:
SIAASGQ SSASECT SFAREGS Initials: _______ _ Date: __ ___ _____ CRN:
Uncheck voice response
Grade Mode: G
Rev. 10/2017
TEACHING ASSISTANCE AND TUTORING COURSE FORM
(For Baccalaureate Degree Courses)
