Petition for Academic Exception

Petition for Academic Exception
INDICATIONS: This form is to be used when the student is seeking an exception of any kind to be made in his/her academic program. Examples include, but are not limited to, substitutions of another course for one required for the degree or waiver of a course.
DIRECTIONS: Consult with your academic advisor regarding this request. Submit the completed form.
Full Name *

First Name Last Name
Date *

Month Day Year
E-mail *
Phone Number

Area Code Phone Number

Address *

Program *

MAMFT MACMHC MSPS MAMin MASFD
Specialization(s) or Certificate(s) *
Request (Please describe your request in detail and include any supporting information): *
Student Advisor *
Should be Empty: