Get Student Request Form

CONCORDIA UNIVERSITY FACULTY OF ARTS AND SCIENCE STUDENT REQUEST FORM Student Academic Services Loyola AD-202 Guidelines please read carefully State your request clearly and concisely. Explain the reason you are making this request. When referring to a course state the course number and section e*g* FRAN211/2-AA. Include a current copy of your student record on your MyConcordia portal or available at LB-185 and supporting documents e*g* medical certificates instructor s notes course description s. Failure to do so will delay processing of your request. All requests must be signed by a departmental advisor. PLEASE PRINT THE ADDRESS WHERE A RESPONSE IS TO BE SENT First Name Family Name I. D. Address Phone City Province Fax Postal Code e-mail address Department Program of Study Check appropriate box es Late Disc1 Late DNE2 Late Course Change3 Credit Overload4 Extension Late Completion Deadline5 Late Registration6 Transfer External Credit s 7 Course Substitution8 Remove Exemption9 Retain Credit10 Waive 24 Credit Rule11 Receive Credit for INTE 29012 Waive Residency Requirement13 Gen* Ed. Requirement14 Other15 Supporting Documentation list REQUEST Please state your request clearly. If you wish you may attach a letter or additional sheets of paper. Student s Signature Date FOR DEPARTMENTAL ADVISOR S USE ONLY Comments Departmental Advisor s Name please print January 2004 Date Fax 514 848-3092 FOR STUDENT ACADEMIC SERVICES Faculty Academic Counsellor s Signature. Explain the reason you are making this request. When referring to a course state the course number and section e*g* FRAN211/2-AA. Include a current copy of your student record on your MyConcordia portal or available at LB-185 and supporting documents e*g* medical certificates instructor s notes course description s. Include a current copy of your student record on your MyConcordia portal or available at LB-185 and supporting documents e*g* medical certificates instructor s notes course description s. Failure to do so will delay processing of your request. All requests must be signed by a departmental advisor. Failure to do so will delay processing of your request. All requests must be signed by a departmental advisor. PLEASE PRINT THE ADDRESS WHERE A RESPONSE IS TO BE SENT First Name Family Name I. D. Address Phone City Province Fax Postal Code e-mail address Department Program of Study Check appropriate box es Late Disc1 Late DNE2 Late Course Change3 Credit Overload4 Extension Late Completion Deadline5 Late Registration6 Transfer External Credit s 7 Course Substitution8 Remove Exemption9 Retain Credit10 Waive 24 Credit Rule11 Receive Credit for INTE 29012 Waive Residency Requirement13 Gen* Ed. PLEASE PRINT THE ADDRESS WHERE A RESPONSE IS TO BE SENT First Name Family Name I. D. Address Phone City Province Fax Postal Code e-mail address Department Program of Study Check appropriate box es Late Disc1 Late DNE2 Late Course Change3 Credit Overload4 Extension Late Completion Deadline5 Late Registration6 Transfer External Credit s 7 Course Substitution8 Remove Exemption9 Retain Credit10 Waive 24 Credit Rule11 Receive Credit for INTE 29012 Waive Residency Requirement13 Gen* Ed. Requirement14 Other15 Supporting Documentation list REQUEST Please state your request clearly. If you wish you may attach a letter or additional sheets of paper.