Take Five Course Change Petition

Complete your contact information and the appropriate section(s) for your request. A copy of this form will be sent to the Take Five Administrator. Expect a response within five business days.

Your Contact Information


Term Change Request

I am notifying you that I will be taking my originally approved course(s), but not during the term(s) I originally planned to. My new plan is to take the course(s) in the term(s) and year(s) listed below.
(Please provide course numbers only, e.g. MTH 161)


I would like to replace a previously approved course with a different course. (Please provide the course numbers and titles and term, e.g. MTH 161, Calculus 1A, Spring 2007)