UNDERGRADUATESTUDENT PETITION

Office of the Registrar
University of California, San Diego
9500 Gilman Drive, 301 UCtr
La Jolla, California 92093-0021

INSTRUCTIONS: Check appropriate box.
DEPARTMENTAL EXCEPTIONS: Select this option if you are requesting any departmental exceptions including course
substitutions. If a course does not appear on an approved list published in the general catalog, department publications orapproximation chart, SUBMIT this petition to your MAJOR DEPARTMENT. Remember to include a course number andindicate whether the course is lower or upper division.
COLLEGE EXCEPTIONS: Select this option if you are requesting any college exceptions including General Education
course substitutions. If a course does not appear on an approved list published in the general catalog, college publications
or articulation agreement, SUBMIT this petition to your COLLEGE ADVISING OFFICE.
SUMMER SESSION: Select this option if you are requesting any exceptions to the general rules governing summer session.
UNIVERSITY EXCEPTIONS: Select this option if you are petitioning for reasons other than the above, but which are
exceptions to University Policy. Please check with your College Advising Office regarding appropriate signatures.
Name:_____________________________________________

P.I.D.#:_______________________ Class Level:_______

Current Address:____________________________________

E-Mail Address:__________________________________

City:_______________________ State:______ Zip:_______

Local Telephone: (_____)__________________________

Major:____________________________________________

College:_________________________________________

LastFirstMiddle

IF APPROVED, YOUR PETITION WILL BE PLACED IN YOUR FILE.
IF DISAPPROVED OR APPROVED WITH CONDITIONS, YOU WILL BE NOTIFIED.
If UCSD course: Subject: ___________ Course #: ______ Grade Option: ______ Units: _______ Section ID: ___________ Term:_______
If UCSD course: Subject: ___________ Course #: ______ Grade Option: ______ Units: _______ Section ID: ___________ Term:_______

REQUEST: (IF you are petitioning a non-UCSD course attach a copy of the catalog course description.)_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________REASON FOR REQUEST:_____________________________________________________________________________________________________________________________________________________________________________________________________________STUDENT SIGNATURE:_______________________________________________

DATE:___________________For Official Use Only

APPROVAL_________________________________________
Instructor/Faculty Advisor

Date

DISAPPROVAL__________________________________________
Instructor/Faculty Advisor

Date_________________________________________________________________________________________________

Department ChairDepartment Chair

Date___________________________________________________
College or Summer Session Director (Summer Only)

Date

Date

________________________________________________
College or Summer Session Director (Summer Only)

Date

Pending receipt of official transcripts verifying
appropriate transfer credits and grade.

COMMENTS:_____________________________________________________________________________
Distribution:

College - cc: Registrar when necessaryDepartment or Summer Session
when necessaryStudent copy

Grade Report
Registrar : ______________________

ISIS

Date: _______________
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