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mm/yyyy Are any of the courses selected designated (Daemen College)

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  • 11 check-boxes
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PERMISSION TO ENROLL
Office of the Registrar
DS 120
Office of the Registrar
8/2018
STUDENT NAME: __________________________________________ DATE: ____________ STUDENT ATHLETE □ YES □ NO
MAJOR: ____________________________________ STUDENT ID NUMBER: _______________________ ANTICIPATED GRAD YEAR: ___________
mm/yyyy
Are any of the courses selected designated as Service Learning courses: □ YES □ NO. IF YES, consult the Service Learning Office for the appropriate Service
Learning permission form. Thank you.
TERM: CHECK ONE: □ FALL ________ □ INTERSEMESTER ________ □ SPRING ________ □ SUMMER ________
Year Year Year Year
CHECK ONE OR MORE OF THE FOLLOWING AS APPROPRIATE: I am requesting permission to:
□ Enroll in a closed course
□ Waive the course prerequisite and/or corequisite
□ Instructor’s permission is required
□ Other: Please explain: ___________________________________________
PLEASE NOTE: Students will be asked to provide proof of Advisor’s approval of the course on their worksheet.
DEPT PREFIX
COURSE
NUMBER
SECTION
COURSE TITLE
CREDIT
HOURS
INSTRUCTOR
COURSE:
COURSE:
COURSE:
COURSE:
COURSE:
REQUIRED SIGNATURES
Please sign the form and secure only the required signature(s)
___________________________________________ ____________ __________________________________________ ____________
Student’s signature Date Instructor’s signature (if applicable) Date
__________________________________________ ____________ __________________________________________ ____________
Department Chair’s signature (if applicable) Date Instructor’s signature (if applicable) Date
__________________________________________ ____________ __________________________________________ ____________
Advisor’s signature (if applicable) Date HEOP/Vision Program Officer’s signature (if applicable) Date
____________
Date
__________________________________________
Athletics Director or
Director of Compliance Signature
□ FOR REGISTRATION OFFICE USE: Education Plan, indicating course approval by Advisor, was reviewed.
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mmyyyy Are any of the courses selected designated (Daemen College)

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Completed 19 August 2020

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