UT MARTIN GRADUATE STUDENT SPECIAL REQUEST FORM
Only one type of request per form (Rev 7/06)
Name
ID Date
Address
City, State Zip
Cum GPA
Advisor Major/Concentration
Circle Type of Request Below Follow Instructions Below. If not excluded below, will require approval by the Graduate
Council as well as the College Committee.
Substitution Provide information below about course(s) completed and what required course
it/they should substitute for.
Does not require Council/Dean of Graduate Studies approval.
Transfer Credit
(specify institution)
Provide course information below. If there is no equivalent course, identify discipline and
course level.
Attach copy of course description from catalog of transfer institution. Official
transcript must be on file in Graduate Studies Office.
NOTE: Acceptance of this request prior to the semester in which you graduate is provisional
since coursework more than six (6) years old may not be applied toward a master’s program.
Requires College Committee and Graduate Council approval
only if request exceeds transfer
credit rules in catalog—see Academic Regulations, Transfer Credit.
Extension of Time Provide information below for course(s) taken. If approved, the method for validating
course(s) that are older than six (6) years must be by
Written Examination(s). The examination
for each course must be filed in Coordinator’s Office.
Validation will occur by (specify date): .
Other
(specify type)
Under “COMMENTS,” explain nature of the request and why it should be approved.
COURSE(S) TAKEN:
1.
( )
Discipline Abbrev. Course # Course Title (abbreviate if necessary) Sem. Hrs. Term/Yr. Grade
substituted for/equivalent to:
( )
(circle one of above) Discipline Course # Course Title (abbreviate if necessary) Hrs.
2.
( )
Discipline Abbrev. Course # Course Title (abbreviate if necessary) Sem. Hrs. Term/Yr. Grade
substituted for/equivalent to:
( )
(circle one of above) Discipline Course # Course Title (abbreviate if necessary) Hrs.
COMMENTS:
Student’s signature Date
Support
Do Not Support
Graduate Advisor Date
Support
Do Not Support
Graduate Coordinator Date
Approved
Disapproved
College Committee Date
Approved
Disapproved
Graduate Council/Dean of Graduate Studies Date