Veterans Certification Request Form - Polk State College (Page 2 of 3) in pdf

Veterans Certification Request Form - Polk State College Page 2

Section V: Academic Advisor Certification (In lieu of a DAUDR, otherwise known as a Degree Audit, please see a Polk

State Academic Advisor and request that he/she complete Section V of this form.)

Please note, if the above individual is a transient student, a Polk State academic advisor is not required to complete

Section V, and the student must submit this form with a transient form from his/her home college listing the courses

approved for concurrent study.

What is the above student’s primary major? ________________________________________________

Is the above primary major a certificate program? ___________________________________________

Has this student applied for graduation at the conclusion of the current term? ____________________

A. Polk State Veteran: Please list all registered courses below.

Course Title

Course ID

Clock/Credit Hours

B. Polk State Academic Advisor: Please complete the following statement as it pertains to the above student.

All classes detailed above are necessary for the student’s primary major at Polk State College.

YES ____

NO ____

Please list any courses that do not apply to the student’s primary major at Polk State College below.

Course Title

Course ID

Clock/Credit Hours

Polk State Academic Advisor’s Name (Print): __________________________ Phone Ext.: ___________

Signature: __________________________________

Date: ________________________________

Veterans Certification Request Form - Polk State College Page 2