Graduate School of Arts and Sciences
Instructor Approval Form
Special Students
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This form must be signed by the appropriate instructor(s) and returned to the Graduate School of Arts
and Sciences (Kutz 219) along with the Special Student Application.
Once your application is approved and signed by the Graduate School of Arts and Sciences, you must
bring a copy of this form to the Registrar’s Office to complete the registration process.
You are required to fill out a new form each semester or if you add an additional course within a given
semester. You must reapply each academic year to enroll in classes as a non-degree student.
BIOGRAPHICAL INFORMATION
____________________________________________________________________________________________
Last Name
First Name
Middle Initial
____________________________________________________________________________________________
Date of Birth
SAGE ID (for those who have previously taken a course)
COURSE INFORMATION
(1)
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Course Number
Course Name
Instructor
____________________________________________________________________________________
Instructor Signature
Date
(2)
____________________________________________________________________________________
Course Number
Course Name
Instructor
____________________________________________________________________________________
Instructor Signature
Date
(3)
____________________________________________________________________________________
Course Number
Course Name
Instructor
____________________________________________________________________________________
Instructor Signature
Date
GSAS APPROVAL
____________________________________________________________________________________________
Associate Director of Admission
Date