Revised 20180607
Richard W. Riley College of Education
Winthrop University
UNDERGRADUATE COURSE SUBSTITUTION FORM
Purpose: This form is used when requesting the substitution of one course for another required course in order to
fill a prerequisite for graduation.
Student Name
Student Number
Student E-mail
Current Phone
Degree/Major
Advisor
Based on the requirements of the ______________________ Catalog, I am requesting that:
____________________________________________________________________________________________________________
(Requested Course Title and Number)
substitute for ______________________________________________________________________________________________
(Required Course Title and Number)
Rationale (REQUIRED):
Student Signature ____________________________________________________________________ Date ________________
Advisor Recommendation: _____ Yes _____ No
Advisor Signature ____________________________________________________________________ Date ________________
Department Chair Recommendation: _____ Yes _____ No
Department Chair Signature __________________________________________________________ Date ________________
AFTER OBTAINING ADVISOR AND DEPARTMENT CHAIR SIGNATURES,
SUBMIT THIS FORM TO: STUDENT ACADEMIC SERVICES, 144 WITHERS
Student Academic Services Approval: _____ Approved _____ Not Approved
SAS Signature _______________________________________________________________________ Date ________________
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signature
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