Graduate Petition To Change Class Schedule

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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
Course
Department
Course
Sec.
Units
S/U
Repeat?
Instructor's Signature
Date
Code
Control No.
(e.g., Math)
No.
No.
A
A
A
TO BE DROPPED:
Action
Course
Department
Course
Sec.
Units
S/U
Repeat?
Code
Control No.
(e.g., Math)
No.
No.
D
D
D
TO CHANGE UNITS IN VARIABLE UNIT COURSE:
Action
Course
Department
Course
Sec.
Former
New
Instructor's Signature
Date
Code
Control No.
(e.g., Math)
No.
No.
Units
Units
U
U
TO CHANGE GRADING OPTION (check desired option):
Action
Course
Department
Course
Sec.
Letter
S/U
Code
Control No.
(e.g., Math)
No.
No.
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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