PETITION TO GPEC TO COUNT OUTSIDE COURSEWORK
(submit one form for each course)
Name:__________________________________
Email Address_______________________________
Advisor’s Name_______________________________________________________________________
Outside Course Name, Dept, Univ.________________________________________________________
When (to be) Taken?______________________Grade Received (if already completed)_____________
Do you want transfer credit for this course? __________________ If yes, for what degree? ________
IF THEY TRANSFER FOR THE MS WILL IT COUNT LATER TOWARDS THE PHD? _____________________
Do you want to count the course
(1) as a CSD elective _________________,
(2) as credits only, __________________,
(3) to place out of a CSD foundation course requirement, _________ (require additional approval)
Briefly explain the reason for this request: _________________________________________________
_____________________________________________________________________________________
Student’s Signature:______________________________________ Date: _________________________
Please attach the following:
Official transcript (for courses already completed)
Explanation of the course numbering and grading system and statement of departmental
requirements at the University where the course was taken (for courses already completed)
Course syllabus
Course description. EXAMS AND ASSIGNMENT DESCRIPTIONS
Please refer to the “Department of Computer Science Regulations for Graduate Studies” for further
information about counting outside coursework.
The signature from an instructor of equivalent course in CSD, or a CSD faculty member in closely
related area (if there is no equivalent course) is required for counting outside coursework.
Equivalent/Similar/Closely related CSD course: _____________________________________________
Instructor/CSD faculty member Name: ____________________________________________________
Signature: _________________________________
Date: ___________________________________
If the transferred course is to place out of a CSD foundation course requirement, the CSD faculty
member needs to sign this section.
I certify that
(1) I taught the corresponding foundation course within the past two years; and
(2) the knowledge that the student gained in the transferred course meets the grade requirement of CSD
foundation courses for PhD students.
Instructor/CSD faculty member Name: ____________________________________________________
Signature: _________________________________
Date: ___________________________________
Form Rev. Summer 2014