ALICE LLOYD COLLEGE

ACADEMIC STANDING PETITION

STUDENT’S NAME ______________________________              ID# _________           DATE ____________

STUDENT’S CUMULATIVE GRADE POINT AVERAGE                           ______________

TOTAL CREDIT HOURS ACCUMULATED                                                                        ______________

            If student transferred hours from any other schools to Alice Lloyd College,

List number of hours accepted from Two Year Community College(s)               _____

List number of hours accepted from Four Year College(s) and/or University(ies)            _____

FOR REQUESTS PERTAINING TO A STUDENT’S PROGRAM REQUIRING APPROVAL OF THE DEAN OF THE COLLEGE (COURSE TO BE ARRANGED, INDEPENDENT STUDY, COURSE OVERLOAD, ETC.)

I HEREBY REQUEST THE FOLLOWING FOR THE Fall/Spring SEMESTER OF THE YEAR _______:

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STUDENT’S SIGNATURE                ________________________________________    Date: _____________

INSTRUCTOR’S SIGNATURE         ________________________________________    Date: _____________

MAJOR ADVISOR’S SIGNATURE ___________________________________  Date: _____________

(If Educ) TEP ADVISOR’S SIGNATURE      ___________________________________  Date: _____________

ACADEMIC DEAN’S SIGNATURE ___________________________________  Date: _____________

IF THIS PETITION IS FOR AN INDEPENDENT STUDY, A COURSE OUTLINE MUST BE ATTACHED.