EASTERN MICHIGAN UNIVERSITY
Graduate School
PETITION FOR MODIFICATION OR WAIVER OF
GRADUATE SCHOOL ACADEMIC AND ADMINISTRATIVE POLICIES

1. Type or print your name and address in the space below. A copy will be returned to this address with The Graduate School’s decision indicated. Please also provide the information requested at the right.

Name

Address

City, State, ZIP

 
Student ID Number: ___________________
Phone: _____________________________________
Academic Program: ___________________________
Degree Level: ________________________________
Period of Last Enrollment:
                                 TERM: _____          YEAR: ______

2. Read the directions at the top of this form. Then use the space below to type or print your request. Attach a separate sheet if necessary.

 

 

 

 

 

3. Signature of Student: ________________________________________________ Date: ____________________

4. Instructor’s Decision: I do _____   do not _____   support this petition. Comments (if any) are attached.

Signature: __________________________________________________________ Date: ____________________

5. Department Head or Graduate Program Adviser Decision: I do _____    do not _____    support this petition. Comments (if any) are attached.

Print Name: __________________________________________ Department of: ____________________________

Signature: ___________________________________________________________ Date: ____________________

Forward this form to Graduate School, 200 Boone Hall, Eastern Michigan University, Ypsilanti, MI 48197. FAX: 734.487.0050

6. Graduate School Decision: ____________________________________________________________________________________________
____________________________________________________________________________________________

Signature: _______________________________________________________________ Date: ________________