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APPLICATION For GRADUATE TIME EXTENSION

For matriculated Graduate Students who have exceeded the time limit allowed for the completion of their degree, are required to file an application for time extension of the Registrars Offices, Room 217 HN. This time extension must be approved and signed by both the Graduate advisor and Division Dean. Please do not submit this form to the Registrars Office without the required signatures. The total time limit for completing all degree requirements is 4 years except for programs in education, Nursing, Health Sciences, and Social Work where the time limit is 5 years. Your time is calculated from your first semester in a matriculated program, excluding the Summer Session, to the end of your final semester: 8 semesters for a 4 year program, 10 semesters for a 5 year program. Courses exceeding the limit at graduation will not be included in degree credits unless approved by the graduate advisor AND Division Dean.

Name: __________________________________________________________________________
                Last                                       First                         Middle                             Maiden/Other

Address:_________________________________________________________________________
                Number and Street                       Apt #                  City               State           Zip Code

ID # (Social Security#) _______/______/________

Curriculum: ___________________________

Home Telephone: (______)________________

Work Phone: (______)__________________

If  you are not in attendance for this current semester, have you applied for readmission?

___ Yes

___ No

If yes for which semester?

______Fall

_______Spring

_______Summer

Student's Signature__________________________________

Date ______/_______/______

***TO BE FILLED OUT BY YOUR GRADUATE ADVISOR AND DIVISIONAL DEAN****

________ Your application  for an extension of time to complete your program has been denied
________ Your application for an extension of time to complete your program has been granted
                 UNTIL (Month)______________

(Year)_____________________

Please list all out of date courses that have been approved toward degree:
Semester Taken Discipline Number               Course Title
____________ ____________ ____________ ________________________
____________ ____________ ____________ ________________________
____________ ____________ ____________ ________________________
GRADUATE ADVISORS SIGNATURE ________________________________

Date____________

DIVISIONAL DEAN'S SIGNATURE

________________________________

Date____________