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SEMESTER/YEAR:

THE GEORGE
J Spring
TODAY€ DATE: (MM/DD/YY)
WASHINGTON oF THEREGISTRAR
OFFICE J S u n l n l e r-

U N I VERSI TY REGISTRATION TRANSACTION FORM tr rall


WASIIINGTON DC

S f u d e n ltD N u m b e r Losf Nome Firsi Middle Dote of Birth


GURRENTADDRESS: FOROFF.GAflIPUS & VA GAftTPUSSTUDENTS
ONLY: CAIhPUS: STUDENTLEVEL:
Street: Empl,lyer:
E Main CampusMVC tr 00 Nor-r-Degree
Cirv: Stute: Zrlt- Citi': E Mrginia Campus tr Ot UndergradLrate
L)a1'Pl'roneNumb..,( ) [| OZGraduate
IWLITARYSTATUS: tr N'tilitary,
ActiveLr.n'
tr ort Campus
E.r'eningPhoneNr.,nrber'(
t 04 La*
i-l Vrcation,l| ftghllbili1a1iqrn E Militarl,, Retiretl
ll Reservist f Militarv, De1-rs11.ls1)1 tr os Medicine
Email Address:

I N S T R U C I I O N S : C O P Y C R N . D E P TA. B B R E V I A T I O N
C.O U R S EN O . . S E C T I O NA N D C R E D I TH O U R SF R O MT H E S C H E D U L E
OF CLASSES Groding Options
lnsfructor or Deporlmentol Approvol
C O U R S E SECTION CREDIT S i g n o t u r e- C o m m e n t s
CRN DEPT.
ABBR.
NUMBER HOURS
COURSE
TITLE A c P R

7il

ChangeGradingStatus- Optior-rs:
A: Audit
C : Letter Grade
P : PassA'.lo
Pass(undergrctdllLfte
onlJ)

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R : Credit,A.JoCredit (gradurrteonly)
Tb OverrideClosureor Time ConflictReqr,riresInstructor
SignatureApproval
or Deparrtmental

lJ I requestthe aboveaction be performed. Tirdrry'sDate: For Official UseOnly Dean's Signature*:


ACTIOil fO BE IAKEN:
Today's Date:
f Ini ri alR egi srrari on
Studcnt's Signature:
[l ProgramAdjustment (dropladd,gradetylte) Approved Effective Date (affectsrefund rnte)'t:t,
E Cc,.rrseWithdriiw ('V" gradeoppliecl) * required afier ccrt:rin deadline datcs *'r to lrc fillcd in h1'arpprover onlr'

9/O3
W H I T E- R E G I S T M R YELLOW- FILE P I N K- S T U D E N T

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