COUNSELING, EDUCATIONAL PSYCHOLOGY & SPECIAL EDUCATION *********************************************************** Application for MQM Doctoral Course Equivalency *********************************************************** Students requesting a MQM/CEP PhD course waiver are required to should fill out this form, attach a syllabus and obtain an official transcript for each course listed. Note that a passing grade (i.e., C or above) should be reported in the official transcript for the specific course (or courses) that the student asks to waive. Also, note that by waiving a course (or courses) the student will not receive any credit hours for that course (or courses), but the student will be allowed to request an override for enrollment in courses for which the waived course (or courses) is a prerequisite (enrollment is subject to approval of override request by course instructor). For each of the courses that a student is requesting a waiver, he or she must have the signature of the MQM faculty member who has taught the course (or courses) most recently and the student’s adviser. Submit the completed form (signed by the MQM faculty and the student’s adviser) to the Graduate Office for student’s official file (Michael Sedlak’s office). Retain a copy of the completed form for your personal files, to use when requesting a course override, and to attach to your Plan of Study. 1. Name Address Student Number (PID) (Street address) 2. E-mail address 3. Ph.D. Program Code (City) (State) (Zip) Phone Advisor Course(s) to be reviewed as an equivalent course at Michigan State University. Prior Coursework University Name Crs. No & Name Credits MSU Courses Grade Textbook Crs. No. Approval Statement by Reviewing Faculty: I have reviewed the course(s) and have initialed for EACH approved course equivalency (and signed below). MQM Course Program Signature – Reviewing Faculty Date Signature - Student’s Advisor [ ] Copy sent to the Graduate Office for student’s official file MQMcourse waiverapplicationform.doc Rev. 11/30/12