Graduate Petition to Change Class Schedule - University of California, Berkeley

UNIVERSITY OF CALIFORNIA, BERKELEY OFFICE OF THE REGISTRAR
GRADUATE PETITION TO CHANGE CLASS SCHEDULE
for the
Fall
Spring Semester 20___
(NOTE: THIS FORM MUST BE COMPLETED IN BLUE OR BLACK INK ONLY.)
Name _________________________________________________________ SID No. ________________________
last first middle
Local Address __________________________________________________________________________________
street city/state zip
Telephone No. ( ) _________________ College/School ___________________ Major __________________
TO BE ADDED:
Action
Code
Course
Control No.
Department
(e.g., Math)
Course
No.
Sec.
No.
Units S/U Repeat? Instructor's Signature Date
A
A
A
TO BE DROPPED:
Action
Code
Course
Control No.
Department
(e.g., Math)
Course
No.
Sec.
No.
Units S/U Repeat?
D
D
D
TO CHANGE UNITS IN VARIABLE UNIT COURSE:
Action
Code
Course
Control No.
Department
(e.g., Math)
Course
No.
Sec.
No.
Former
Units
New
Units
Instructor's Signature Date
U
U
TO CHANGE GRADING OPTION (check desired option):
Action
Code
Course
Control No.
Department
(e.g., Math)
Course
No.
Sec.
No.
S/U
Letter
Grade
O
O
TOTAL NUMBER OF WORKLOAD UNITS ON STUDY LIST: Before change _____ After change______
ARE YOU AN ACTIVE INTERCOLLEGIATE (NCAA) STUDENT-ATHLETE FOR THIS SEMESTER? Yes____ No____
REQUIRED SIGNATURES - see reverse for instructions
___________________________________________________ __________________
Processed by ___________
Student Date
___________________________________________________ __________________ Date _________________
Head Graduate Adviser Date
___________________________________________________ __________________ Comments ____________
Dean of the Graduate Division Date
___________________________________________________ __________________
Faculty Athletic Representative Date
___________________________________________________ __________________ OR-Reg 08/05
Veterans' Services Date
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