Ini Petition Form

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Date of Submission:
Purpose of Petition:
(Program transfer, independent study, proposal submission extension, increase in units, course substitution, etc.)
Last (family) Name: _________________________________
First Name: ___________________________
MSIN
Program:
Year Entered: _____________
Andrew ID: ___________________________
Supporting material explaining petition request:
(Please be as detailed as possible. If making a request regarding specific courses include the course number and title.)
 
 
Do not type below this line- INI ESO use only
Petition approved
Petition approved with conditions:
Petition denied for the following reason:
INI Graduate Programs Academic Advisor Committee Decision Date:
Processed By
Reviewed by Committee
Saved E-Copy
Notified Student
Updated Track Sheet
Filed in Student's File
Submit your completed form to the INI Enrollment Services office at ini-enrollment@andrew.cmu.edu
06/15

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