GARDNER-WEBB UNIVERSITY
Permission to Register for Course by Arrangement
**This form must be submitted prior to the start of classes for the term**

Course Dept. & Number__________________ Course Title ____________________

Number Hrs. Credit _______  Fall  Spring  Sm1  Sm2  10wk     Year________
                                                                    (Circle one)

Student's Name________________________________ ID No. ________________

Address______________________________

City, St., Zip___________________________

____________________________________        ______________________
(Student's Signature)                                                                       (Date)

Reason for requesting the course by arrangement: ________________________________________

______________________________________________________________________________

____________________________________        ______________________
(Faculty Advisor's Signature)                                                         (Date)

Registrar's Verification: (Check One)
__________The requested course is not offered during the semester indicated. It will be detrimental to the student's academic progress to delay taking the course until it is next offered.
__________The requested course is offered, but after exploring all reasonable schedule modifications, the student is unable to schedule it.

Registrar's Signature_________________________ Date___________________
APPROVAL OF FOLLOWING REQUIRED:

_________________________________ ______________________________
(ProfessorTeaching Course) (Date)

_________________________________ 
______________________________
(Dean / DepartmentChair) (Date)

________________________________
______________________________
(Associate Provost) (Date)

Catalog Policy: "A course by arrangement is restricted to a catalog course which is not offered by the University during a given semester or cannot be scheduled by the student. The course might be offered to the student on a one-to-one basis. The option is limited to instances of extenuating circumstances." Verification of the Registrar, approval of the professor responsible for the course, dean / department chair, and Associate Provost is required.

Original-Registrar            Copies-Professor of Course/Advisor/Student