Petition for Dual Enrollment For

GraduateSchool

NorthwestMissouriStateUniversity

Petition for Dual Enrollment for

Undergraduate Credit For Graduate Students

(Undergraduate credit cannot be used towards a Masters degree.)

To: Associate Provost of Graduate and Professional Studies

Date:

Name:

Student ID #:

Trimester: Spring Summer Fall Year:

I am a Graduate Student at Northwest and understand the undergraduate course indicated below can not be used towards my master’s degree. I will complete undergraduate course requirements. The undergraduate grade earned will not count toward my graduate GPA. This form must be completed within the first week of class. I hereby apply to take (#) semester hours of 500 levelundergraduate study as a dually enrolled Graduate Student. I understand that my total load cannot exceed 16 hours in a trimester with no more than seven hours in a four-week summer session, that I will pay undergraduate fees for the 500 level undergraduate class(es) and pay regular graduate fees for graduate classes which will count towards my degree. I also understand that I cannot request graduate credit for this(these) courses at any time in the future.

My graduate schedule will be as follows:

Department / Course # / Section # / Course Title / Semester Hrs. / Session

I hope to take the following 500 level course(s) asundergraduate credit and will consult with the appropriate graduate advisor.

Department / Course # / Section # / Course Title / Semester Hrs. / Session

Graduate School: Approval is noted and this petition is filed with the Northwest Missouri State University Graduate Office. The student has been advised that he/she will be allowed to take 500 level classes indicated above and pay undergraduate fees and be awarded undergraduate credit for the 500 level class(es), however the credit will not count towards a Master’s degree. Changes may not be made without theassociate provost’s approval.

Student Signature: Date:

Graduate Program Advisor Signature:Date:

Associate Provost of Graduate and Professional Studies

Signature: Date:

NN 11/02/06
ZR 7/28/16