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Petition Form PDF

This document is a petition form for graduate students at Assumption University to request actions from the university, including adding or withdrawing courses, changing sections or programs, or requesting make-up exams or to maintain student status. The form requires students to provide their name, address, admission ID, program of study, the specific request and reasons for the request, with signature lines for approval from the graduate school, advisor, department chair, student, and vice president of academic affairs.

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Adnan Kamal
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128 views1 page

Petition Form PDF

This document is a petition form for graduate students at Assumption University to request actions from the university, including adding or withdrawing courses, changing sections or programs, or requesting make-up exams or to maintain student status. The form requires students to provide their name, address, admission ID, program of study, the specific request and reasons for the request, with signature lines for approval from the graduate school, advisor, department chair, student, and vice president of academic affairs.

Uploaded by

Adnan Kamal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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ASSUMPTION UNIVERSITY

GRADUATE SCHOOL Serial No. _____________________

PETITION Study Program _________________

INSTRUCTION: Fill up your request clearly and completely.

This petition may be used to request several actions by the University. A separate petition is required for each request and covers
only the specific request you are making.

Mr. Ms. Mrs. Admission I.D.: [ ][ ][ ]--[ ][ ][ ][ ]


NAME:
Name Surname

ADDRESS: ___________________________________________________________________________________________________
____________________________________________________ Tel. _______________________________________

State specific request, outlining completely pertinent facts and details to support your request.
Attach additional sheet if necessary.

REQUEST FOR:

Add Course(s) Change Section Make - Up Exam

Withdraw Course(s) Change Subject Audit for Comprehensive

# Subject & Section: ___________________________________________________________________________


# Instructor Name: _______________________________Semester: ___________________________________

Maintain Student status Change Program Transfer Credit(s) Other


#___________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________

______________________________________________________________________
Reasons (s):
_______________________________________________________________________________
SIGNATURE _______________ DATE ___/___/___

Graduate Schools' comments/approval Advisor or Dept. Chairperson's comments/approval


______________________________________________ __________________________________________________
______________________________________________ __________________________________________________
______________________________________________ __________________________________________________
______________________________________________ __________________________________________________
______________________________________________ __________________________________________________
Signature _____________ Date ___/___/___ Signature ______________ Date ___/___/___

Student's Acknowledgement ACADEMIC ACTION


Fine/Fee receipt. No. Approved Rejected

Amount due Comments

Signature ______________ Date ___/___/___ Signature _______________ Date ___/___/___


Vice President for Academic Affairs
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Please Fill Out This Part For Office Use Only


Admission I.D. [ ][ ][ ] -- [ ][ ][ ][ ] Serial No. ____________
Program of Study: ___________________________ Please contact the Office of Graduate School
Mr. Ms. Mrs. __________________________________ #_________________________________________________________
Request for ___________________________________ _________________________________________________________
_______________________________________________________ _________________________________________________________
Submission Date ____/____/____ Staff Signature _____________ Date ___ / ___ / ___

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