EASTERN MICHIGAN UNIVERSITY
Education First
Graduate School
GRADUATE STUDENT REQUEST TO ENROLL IN A 400-LEVEL COURSE
(Graduate credit may NOT be earned for 100-300-level courses.)
GRADUATE STUDENT completes this section:
Name: ________________________________
Student Number: ____________________________
E-mail address: _________________________
Phone: ( ) ________________________________
Street: ________________________________
City, State Zip: _____________________________
Be sure course is PRE-APPROVED for graduate credit. See list on the Web @
http://gradschool.emich.edu/student/student_subdir/current_stud/approved400level/app400level.html
I request permission to enroll in the following 400-level course during the following semester/year:
Fall 20____
Winter 20____
Spring 20____
Summer 20____
List complete course number and title: ______________________________________________________
Note: I understand that I must complete different or additional work in order to earn graduate credit.
REQUIRED:
Student Signature: _______________________________________________________
Date: ______________________________________
FACULTY/INSTRUCTOR completes this section:
Note: When graduate students participate in 400-level courses, additional material must be covered or projects
assigned in order to qualify for graduate credit. Attach the official 400-level course syllabus to this form. In the
space below, please specify what additional course materials and/or assignments will be assigned to merit the
graduate-level designation or indicate information is on the syllabus. Include graduate-level learning objectives.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Print Instructor Name: ___________________
REQUIRED:
Department/School of: _______________________
Instructor’s Signature: _____________________________________________
Date: ______________________________________
ACADEMIC ADVISOR completes this section:
Up to nine (9) hours of approved 400-level courses may be taken for graduate credit and be applied to a graduatedegree program. (Special Topics – 477/478/479 and Independent Study - 497/498/499 courses ARE NOT
APPROVED!) Courses must appear on (or be added to) the Program of Study.
REQUIRED:
Graduate Advisor’s Signature: _______________________________________
Date: ______________________________________
RETURN THIS FORM TO THE GRADUATE SCHOOL, 200 BOONE HALL. Fax: 734.487.0050.
For Records Office/Graduate School use only:
Request is: [ ] Approved [ ] Denied Signature: __________________________________ Date: _______________
Recorded on Banner __________
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