Graduate Student Spouse Audit Form printable pdf download

Graduate Student Spouse Audit Form

Office of the Registrar

GRADUATE STUDENT SPOUSE AUDITOR'S ADMISSION FORM

Office of the Registrar

Date: ______________________________

Auditor's ID# ______-____-________

Name: __________________________________________________________________________________

(Last)

(First)

(MI)

Email Address: ___________________________________ Day Phone #: ____________________________

School address: ____________________________________________________________________________

Permanent address: _________________________________________________________________________

_________________________________________________________________________

CRN#: ___ ___ ___ ___ ___ Course & Section Number: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___

subject

number

section

Credit Hours: ______ Have you ever attended Rensselaer before? No ___ Yes ___

Semester

attending: Fall _____ Spring _____

Summer _____ Session 1___ Session 2___ Session 3___

List all degrees you

have been awarded: ______________________________________________________________________

Spouse's name: ____________________________________________________________________________

Spouse's Student ID#: ______________________________________________________________________

Type of Rensselaer Assistance:

TA ____ RA ____ RPI Fellowship ___

I have read and understand the auditing regulations on the back of this form and agree to abide by them and the

other University regulations as published in the University Catalog.

Auditor's Signature: ______________________________________________ Date: ____________________

Instructor: Your signature indicates that you have room in the course for the student; you feel the student has the

appropriate background for the course; and you have discussed your requirements for a successful completion of

the audit with the student.

Instructor's

Signature: __________________________________Date_________ Name: __________________________

PLEASE MAKE PHOTOCOPY FOR YOUR RECORDS

(10/2009)

Graduate Student Spouse Audit Form