This is a fillable form and must be typed; handwritten forms will not be accepted. Only one UGRD exception per form.
Student Name_________________________________________ EMPLID____________________________ Campus: HBG GP Online
College____________________________________________ School____________________________________________________________
Degree plan (Major) ______________________________________________________ Minor _________________________________________
Catalog Year_____________________________ Application for graduation: No Yes, Term_____________________________________
EXCEPTION REQUEST (Please check the box below that applies and attach required documentation to support request.)
A current DPR and supporting documentation must be attached to this request form.
___A. Bulletin year extension. Through: Semester______________________ Year______________________
___B. Less than 120 hrs. to degree (This request will be granted only in very rare extenuating circumstances that can be documented)
___C. Less than 124/128 hrs. to degree, but meets 120 hr. minimum.
___D. Senior Institution: 60/62/64 hrs.
___E. 300/400 level: 45 hrs.
_ F. USM overall GPA exception (GPA < 2.000) (This request will be granted only in very rare extenuating circumstances)
___G. Major area GPA exception (Major area GPA < 2.000, but USM overall GPA >/= 2.000)
___H. Excessive course repeats (only in semester of graduation after final grades are posted)
___I. Earn 21 of last 30 hours from the University of Southern Mississippi.
___J. Other. Explain below.
Exception request supported
Major Advisor ____________________________________________________ Date _____________________ Yes No
School Director ___________________________________________________ Date _____________________ Yes No
College Dean ____________________________________________________ Date _____________________ Yes No
Provost _________________________________________________________ Date _____________________ Approve Deny
Print Form