Physical Education Substitute Credit Verification Form
Date: _______________
Student Name: ___________________________________________
Grade: ______________
I am choosing to use my participation in ______________________________ as an option for meeting 0.5
credits of the required 1.5 physical education which is required to graduate. I understand that I still need to
earn 26 credits to graduate and the 0.5 credit of physical education I am opting out must be made up in one of
the following subject areas: English, math, social studies or science.
___________________________________
Student Signature
___________________________________
Parent Signature
Coach’s Verification
1. The student participated in either the junior varsity or varsity level sport for an entire season.
2. The student was not out for more than three weeks for injury or illness during the season. If a student
is out for more than three weeks for injury or illness during the season the student must complete a
health pass packet.
3. The student did not have any violation of the Co-Curricular Code resulting in a suspension from
practice for more than 1 week and/or suspension from two or more competitions during the sport
season.
I verify the above statements are true for this student.
___________________________________
Coach Signature
___________________
Date
Guidelines for the option of waiving 0.5 credits of Physical Education
Students may complete an additional one-half credit in English, social studies, mathematics, or science in lieu
of one-half credit of physical education when they participate in a District sponsored WIAA sanctioned sport or
participate on the high school cheerleading/dance team. A required course or credit may not count for the
one-half credit substitution course; the one-half credit substitution course must be in addition to the minimum
graduation credit requirement for the English, social studies, mathematics, or science areas. Physical
Education 9 and 10 are required courses to which the one-half credit substitution cannot be applied.
Participation in the sport itself does not constitute a course and does not qualify for any high school
graduation credit.
The following criteria must be met for participation in a sport to be eligible for substituting an English, social
studies, mathematics, or science course for one-half credit of physical education:
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2
3
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The student must participate in a junior varsity-level or varsity-level sport for an entire season during
grade 11 or the fall season of grade 12.
The student must submit to their counselor a verification form confirming regular attendance at
practices and participation in competitions no later than two weeks after the conclusion of the season.
The student must not have been out for more than two weeks for injury or illness during the sport
season.
The student must not have had any violation of the Co-Curricular Code.
Note: The term “week” means 7 calendar days.
OFFICE USE:
Counselor signature after review of completed request ________________________________ Date______
Registrar signature when recorded in the student’s record ______________________________Date______
3/12/14