Form 36 - Advanced Manufacturing Certificate Approval Form printable pdf download

Form 36 - Advanced Manufacturing Certificate Approval Form

ADVANCED MANUFACTURING CERTIFICATE APPROVAL FORM

Office of the Registrar

INSTRUCTIONS ON BACK

Student RIN#: ______________________________________

Email: ________________________

Day Phone: _____________________

Print Name: __________________________________________________________________________

(first)

(middle)

(last)

Local Address: ________________________________________________________________________

________________________________________________________________________

Visa Type (if not U.S. Citizen, Permanent Resident or Refugee, circle one): F-1 F-2 J-1 B-2

Degree: _________________________ Curriculum: _____________________

Request Certificate in: Advanced Manufacturing

Student Signature: _______________________________ Date: ___________

Is this your FIRST REQUEST or a REVISION? (Circle one).

Grade (must be ‘B’

Course Subject and Number

Course Title

Semester Taken

or better)

ENGR-6960/MANE- 6961

Advanced Manufacturing Processes and Systems

MANE-6800

Manufacturing Systems Integration

ISYE-6600

Design of Manufacturing System Supply Chains

Additional Course From Master List

OR Approved Culminating Manufacturing Experience Description and Dates

Academic Approvals

Manufacturing Forum Chair:_____________________________________________________________________________________________

Date:______________________

Associate Dean of Academic Affairs (School of Engineering):___________________________________________________________________

Date:______________________

Administrative Approvals

International Student Services:____________________________________________________________________________________________

Date:______________________

Form 36 - Advanced Manufacturing Certificate Approval Form