INFORMATION SYSTEMS
PETITION
DIRECTIONS TO THE STUDENT
1.Please indicate the purpose of this petition in the boxes below.
2.Type your petition and attach it to this cover page. Word your petition carefully and clearly, giving reasons for
requesting approval. 3.Attach appropriate documentation in support of your petition.
4.Submit your petition to the IS Department. The form will then be forwarded to the IS Department Chair.
5.You will be notified of the outcome by the IS Co-Op Coordinator. Disputes of this decision will be handled through the
College of Business Dispute Process.
PART I (TO BE COMPLETED BY THE STUDENT)
First Name___________________________________________________________________________ Last Name______________________________________________________________________
CSU ID#________________________________________________________________________________
Primary Phone___________________________________________________________________ Email Address____________________________________________________________________
Street Address_____________________________________________________________________________________________________________________________________________________________
City________________________________________________________________________________________ State________________________________ Zip Code________________________________
Major Field_____________________________________________________________________________
I am petitioning to be allowed to:
A) Begin my first co-op experience without completing all courses of the first four semesters as shown in the
Co-Op curriculum sheet of my major field (I am indicating the missing courses in my petition)
B) Deviate from the alternating work/study sequence
I hereby certify that all information and statements provided by me in this petition are true.
Student’s Signature
___________________________________________________________________________________________________________
Date________________________________
– 2 N D PAGE TO BE FIL L ED O U T BY IS FA CULT Y –
MONTE AHUJA COLLEGE OF BUSINESS · IS CO-OP
1860 East 18th St., BU 344 · Cleveland, OH 44115 · P 216-687-4760 · F 216-687-5448 · E information_systems@csuohio.edu
INFORMATION SYSTEMS
PETITION (CONTINUED)
PART II (TO BE COMPLETED BY THE IS CO-OP COORDINATOR)
Please provide reasons and comments, make recommendation, sign and date, and return this form to the
IS Department Chair.
__________________________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________________
IS Co-Op Coordinator’s Recommendation:
Approve
Not Approve
IS Co-Op Coordinator’s Signature_______________________________________________________________________________________________ Date___________________________
PART III (TO BE COMPLETED BY THE IS DEPARTMENT CHAIR)
Please provide reasons and comments, make recommendation, sign and date. ______________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________________
IS Department Chair Recommendation:
Approve
Not Approve
IS Department Chair Signature___________________________________________________________________________________________________ Date___________________________
MONTE AHUJA COLLEGE OF BUSINESS · IS CO-OP
1860 East 18th St., BU 344 · Cleveland, OH 44115 · P 216-687-4760 · F 216-687-5448 · E information_systems@csuohio.edu