SAN DIFGO STATE UNIVERSITY Office of Advising ond Evaluations Request for Adjustment of Academic Requirement Please print legibly Date: Read: Primary Major; Secondary Major: —__ = ‘ie/Maen Minor ae Phone: ( J E-mail — _ — DRG tammy ——_—_—Expected Graduation Date: Have you applied yet? Yes CNa READ AND FOLLOW DIRECTIONS CAREFULLY This form should be used by undergraduate students requesting an exception to an academic policy or regulation. DO NOT request an adjustment unless you have seen an adviser ar received an official evaluation, Submit this petition, slong with departmental recommendation when required, tothe ASQRRTEAGvEMg COHSSSWISSI ‘Attach the supporting documentation 1. Syllabus from course in question taken at anather institution 3. Copy of departmental advising sheet (or master plan) 2. Copy of your evaluation or graduation evaluation Upon filing this form with the Office of Advising and Evaluations, please allow up to 8-10 weeks for processing. If the request is approved, the adjustment wil be honored on your degree evaluation. If the request is denied, you will receive @ copy of this form in the mail notifying you ofthe decision. Ifthe request is denied because itis in violation of Title V, an executive order from the CSU Chancellor Board of Trustees, and/or SDSU University Senate Policy there is NO APPEAL. In other cases, a denied request may be appealed tothe Dean of the Division of Undergraduate Studies, ‘SPECIAL CONSIDERATION REQUESTED (Include explanation for request) REQUIRED FOR ADJUSTMENTS TO MAJOR & MINOR ONLY ASSISTANT DEAN OF UNDERGRADUATE STUDIES Request recommended by pes easeseseEEESeECe Cl Approved Denied = No Action ‘Signator of Char, Decor, or Designee Sigratre of Deon or Designee Dae COMMEN} FOR UNIVERSITY USE ONLY When approving a course substitution, please initial one ofthe following: ___. The approved course substitution, subject t culation agreements, applies to ALL students (blanket woiver) The approved course substitution applies as an exception for this student only,