Fillable UNDERGRADUATE STUDENT REQUEST FOR PERMISSION TO ENROLL IN (University of Arkansas - Little Rock)

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UNDERGRADUATE STUDENT REQUEST FOR PERMISSION TO ENROLL IN (University of Arkansas - Little Rock)

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Graduate School 2801 South University Little Rock AR, 72204
UNDERGRADUATE STUDENT REQUEST FOR PERMISSION TO ENROLL IN A
GRADUATE COURSE
STUDENT
Student Name : _____________________________________________________ TNumber: _______________
Street Address: ____________________________________________ Phone Number: ____________________
City: _______________________________________ State: _____________________ Zip: _________________
Undergraduate Major(s): ______________________________________________________________________
I lack no more than 15 hours from my bachelor’s degree and have a grade point average of at least 3.0. If
approved, my course load this term will be _____ hours.
Student Signature Date
GRADUATE SCHOOL
The above-named student’s grade point average is ________ on a total of _______ credit hours earned
toward a degree at UALR.
Graduate School Employee Student Name
veried
enrolled as of
Date
ADVISOR ~ INSTRUCTOR ~ PROGRAM COORDINATOR
I request permission to enroll in the following course:
Alpha Code
Course Number
Section
Credits
Title
for undergraduate credit, approved by
to be reserved for graduate credit
Instructor (coordinator may
verify consent and sign for)
GRADUATE SCHOOL
Program CoordinatorDate Date
Graduate Dean Date
Undergraduate Advisor
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UNDERGRADUATE STUDENT REQUEST FOR PERMISSION TO ENROLL IN (University of Arkansas - Little Rock)

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Completed 28 August 2020

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