JUSTIFICATION FOR SUBSTITUTION OF GRADUATION REQUIREMENTS
Last Name First Middle Student Number
Campus Division Degree Major Catalog Being Followed
REQUIRED COURSE |
SUBSTITUTION |
(PREFIX / NUMBER – TITLE – CREDIT)
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(PREFIX / NUMBER – TITLE – CREDIT) (List Transfer Institution, if appropriate.) |
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JUSTIFICATION |
Student’s Signature __________________________________ Date __________________
APPROVED:
_________________________________ ____________ ________________________ ____________
Academic Advisor (if appropriate) Date Division Dean Date
_________________________________ ____________ ___________________________ ___________
Campus Provost Date Vice Chancellor for Learning & Date
Student Development
Form 1413/007(10/04)