Waiver/Degree Modification(s) for Major/Minor/Concentration/Certification
__________________________________________________________________________________________
Name Student ID#
Major/Minor/Concentration/Certification_________________________________ Date___________________
A waiver of the following requirement is requested by the academic advisor in consultation with the
Undergraduate Department Chair/Dean or the Graduate Program Director:
Course Number___________ Course Title________________________________ Credit Hours_______________
Rationale ____________________________________________________________________________________
Credit hours for a waived course do not count toward total degree requirements
A modification of the following requirement is requested by the academic advisor in consultation with the
Undergraduate Department Chair/Dean or the Graduate Program Director:
1. Course Number___________ Course Title__________________________________ Credit Hours_______
From college/university (if not Fontbonne) _________________________________________________________
Replaces required Fontbonne course for: Gen. Ed. Major Minor Concentration Certification
Course Number___________ Course Title__________________________________ Credit Hours_______
Rationale ____________________________________________________________________________________
2. Course Number___________ Course Title__________________________________ Credit Hours_______
From college/university (if not Fontbonne) _________________________________________________________
Replaces required Fontbonne course for: Gen. Ed. Major Minor Concentration Certification
Course Number___________ Course Title__________________________________ Credit Hours_______
Please obtain signatures in the following order:
___________________________________________________________ ______________________________
Student Signature Date
___________________________________________________________ ______________________________
Advisor Signature Date
___________________________________________________________ ______________________________
Department Chair Signature Date
___________________________________________________________ ______________________________
Dean Signature Date
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