A/R 10-4-13
Year: Term:
Students may enroll in two classes that coincide (beginning and/or end times) only if the time conflict has been
approved by the Instructor and the appropriate Dean. Student should allow 7 to 10 working days for a
response. Student Initial
Part II: Instructor’s description of how work will be made up each week:
Part II: Instructor Directions:
1. The instructor must describe how the student will make up the minutes/hours missed. The missed time must be made
up during the same week under the supervision of the instructor of the course.
2. Instructor must submit detailed attendance records to the Dean at the culmination of the term.
3. Attach the specific plans for arrangements created to make up the time missed.
Instructor’s Signature: Date:
Part III: Dean’s comments:
Dean’s Signature: Date:
Office Use Only: Date Student Notified: A&R Staff Initials:
Part I: Student directions
1. Complete the form and take the form to the instructor of the affected class.
2. If (the instructor is under no obligation to complete and sign the petition) the instructor agrees to create a plan to allow
the student to make up the time, the student will then take the form to the appropriate instructional dean.
3. Student will be notified of the outcome of the petition and, if approved, may then register for the conflicting class in
person with photo identification at the Admissions & Records Office.
To be completed by the student:
Student Last Name: First Name: W Number:
Student Phone Number: Student Email:
Conflicting Courses: (course 1 is the class where the time will be missed.)
Course 1: Course Name/Section# / Meeting days/time /
Course 2: Course Name/Section# / Meeting days/time /
Justification for need to take coinciding courses:
Student’s Signature: Date:
Type your justification in the space below.
