Thee University of Texas
itemised: 4/J8/17
R;pGmndeValley
COLLEGE OF HEALTH AFFAIRS
OVER-HOUR PETITION
Maximum hours allowed without approval:
Fall/S rin
18 ho
M Te
4h
s Su
e
Please attach xour current
Please check one:
A
O Fall
offi
rev f can
Spring
l tr
6 hours
& de ee I
to ro e this request
business days from submission datec*,
Summer I
@ Summer II Year:
Student Name:
Student ID#
Expected Graduation Date:
Cellular xuazber:
Home Number:
Total number of hours currently enrolled:
List courses you plan to enroll in
Course Number & Section
(include prefix)
List overload course(s) you need to petition for Course Number & Section
(include prefix)
Email:
+ hours requested:
Course Name
Days/Time Offered
Course Name
Days/Time Offered
Reason7JustiflcatioUPlan ofAction for Request
Students’ Signature:
Date:
APPROVED/DENIED BY:
Approved Denied
Advisor
Approved Denied
Department Chair
Approved Denied
Dean
Academic Hours Adjusted by Listserv Date
Date:
Date:
Date: