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1 �� &#x/Att;¬he; [/
�� &#x/Att;¬he; [/;ott;&#xom ];&#x/BBo;&#xx [1;.68; 34;&#x.896;&#x 177;&#x.012;&#x 51.; ];&#x/Sub;&#xtype;&#x /Fo;&#xoter;&#x /Ty;&#xpe /;&#xPagi;&#xnati;&#xon 0;&#x/Att;¬he; [/;ott;&#xom ];&#x/BBo;&#xx [1;.68; 34;&#x.896;&#x 177;&#x.012;&#x 51.; ];&#x/Sub;&#xtype;&#x /Fo;&#xoter;&#x /Ty;&#xpe /;&#xPagi;&#xnati;&#xon 0;Student Initials _________ Return to: Office of the RegistrarOregon State University, 102B Kerr Administration Building, Corvallis, OR 97331 P 541 - 737 - 4331 | F 541 - 737 - 8123 | registrars@oregonstate.edu of 3 Petition for Late Change of RegistrationAccording to Academic Regulations 7, 11, 12, 13, 18 STOP AND READthe followinginformation before submitting this petition. Complete all sections. The Office of the Registrar must receive the petition by Thursday at noon. Incomplete petitions will be returned to the studentunprocessed his form is to request a onetime exception. The Academic Requirements Committee (ARC) considersexceptionsbased upon the circumstance described in the petition.ircumstances not generally considered valid areLack of awareness of deadlines and other OSU policies. Students are responsible for knowing and complying with the for Tuition Refund Appeal Petitionsregarding course work three year old or olderwill not generally be considereExtenuating circumstances that may be considered validareSTUDENT: By signing below, I certify that I have read this petition and understand the guidelines and my responsibilities in submitting it. I consent to receive communications about this form at the email address I provided on the form. I understand that o Examples Required Documentation Death of an immediate family member Copy of death certificate or obituary Serious physical or mental health situation of student or immediate family member Copy of medical or hospital documentation, letter from counselor or academic advisor Other serious situation or life event Copy of legal documents, police re port , firefighting assignment, etc. Printed Name: _______________________________________Signature: ______________________________________OSUID #: ____________________________ Date: ____________________You will be notified via OSUemail by the Office of the Registrar regarding the outcome of your petition. �� &#x/Att;¬he; [/;ott;&#xom ];&#x/BBo;&#xx [1;.68; 34;&#x.896;&#x 177;&#x.012;&#x 51.; ];&#x/Sub;&#xtype;&#x /Fo;&#xoter;&#x /Ty;&#xpe /;&#xPagi;&#xnati;&#xon 0;&#x/Att;¬he; [/;ott;&

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#xom ];&#x/BBo;&#xx [1;.68; 34;&#x.896;&#x 177;&#x.012;&#x 51.; ];&#x/Sub;&#xtype;&#x /Fo;&#xoter;&#x /Ty;&#xpe /;&#xPagi;&#xnati;&#xon 0;Student Initials _________ Return to: Office of the RegistrarOregon State University, 102B Kerr Administration Building, Corvallis, OR 97331 P 541 - 737 - 4331 | F 541 - 737 - 8123 | registrars@oregonstate.edu 2 of 3 Revised 5/14/2020TERMand YEARfor which you are requesting a late changeof registration:____________________CRN SUBJECT COURSE CREDITSSection Change (e.g.MTH 252 sec 01 to MTH 252 sec 02) providecourse add &drop information on lines below.Course Add ($20 will be charged per course added.)Course Drop($20 will be charged per course dropped.)Course Withdraw(W grade)($20 will be charged per course withdrawChange Grading BasisFromnstructor comment not required) ($20 will be charged per change.)Maximum Credit Hour OverloadDesired Max Total Hours(Instructor comment not required.) Are you an international student? If yes, before submitting your petitioncontact the Office of International Services to have your international advisor complete their respective section on page 3regarding your visa status. Are you submitting this petition due to aextenuating circumstance?If yes, you are required toattach supportingdocumentation with your petition(See page 1for further information.) Do you receive any financial aid, loans, or scholarships? If yes, before submitting your petitioncontact the Office of Financial Aid, as retroactively changing your registration may have negative financial repercussions. P lease attach a ONE PAGE TYPED sheet of paper with your answers to these questio ns. Reason for change? REQUIRED1,2Why were you unable to meet original deadlineor make registration changes in a timely manner? (REQUIRED)1 Academic Requirements Committee considers requests for onetime exceptions to deadlines. Approval is neither guaranteed nor sets precedent for future committee decisions.2 We are required, under law, to report certain types of situations to appropriate campus offices or state agencies,therefore we cannot guarantee that this information will remain private �� &#x/Att;¬he; [/;ott;&#xom ];&#x/BBo;&#xx [1;.68; 34;&#x.896;&#x 177;&#x.012;&#x 51.; ];&#x/Sub;&#xtype;&#x /Fo;&#xoter;&#x /Ty;&#xpe /;&#xPagi;&#xnati;&#xon 0;&#x/Att;¬he; [/;ott;&#xom ];&#x/BBo;&#xx [1;.68; 34;&#x.896;&#x 177;&#x.012;&#x 51.; ];&#x/Sub;&#xtype;&#x /Fo;&#xoter;&#x /Ty;&#xpe /;&#

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xPagi;&#xnati;&#xon 0;Student Initials _________ Return to: Office of the RegistrarOregon State University, 102B Kerr Administration Building, Corvallis, OR 97331 P 541 - 737 - 4331 | F 541 - 737 - 8123 | registrars@oregonstate.edu 3 of 3 Commentsand SignaturesInstructor and advisor support for a petition is considered by the committee, but does not guarantee approval. Late Add: ( REQUIRED ) Beginning date of attendance _______________Does the student have a reasonable chance to complete? Yes NoInstructor:SupportDo Not SupportPrinted NameSignature DateDepartment:SupportDo Not Support Printed Name _____________________________ Signature ________________________________ Date _______________ L ate Drop or Withdrawal : ( REQUIRED ) Instructor:Did the student submit the final (exam, paper, project)? Yes No Noinalfor this courseLast date of academic participation__________________Provide description ofthe nature of student’s last date of particpationand comments.________________________________________________________________________________________________________________________________________________________________________________________________________________ Printed Name _____________________________ Signature ________________________________ Date _______________ Undergraduat e College Head Advisor / Graduate School Dean Comments & Signature : Required for etitions Late Add/Drop/Withdrawal. Degreeseeking Undergraduate and Graduate Students only________________________________________________________________________Printed NameSignature Date International Advisor Comments & Signature : ( REQUIRED for all international students.) Initiation date of reduced course load ______________Have you informed student of immigration implications?Yes No___________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Printed Name _____________________________ Signature ________________________________ Date _______________ Academic Advisor Comments: (RECOMMENDED f or undergraduate students .) __________________________________________________________________________________________________________________________________________________________________________________________________________ Printed Name _____________________________ Signature ________________________________ Date _____________