Please submit this form to your Advisor via your antioch.edu email account. Petitions concerning credit awarded
changes will require approval of the course instructor, Program Chair, and Provost.
Student name: ____________________________________ ID#: _____________________
Advisor name: _______________________ Program: BA Education MACP MBA MFA PsyD
Term & Year for which Petition Applies: _______________________ Today’s Date: _____________
Course Number (if applicable): _____________________________
Please list the policy or procedure for which you wish to request an exception:
(Example Policy: A course incomplete must be completed by the end of the subsequent term.)
Please list your requested exception to this policy or procedure:
(Example Exception: I would like to extend the incomplete deadline for my Summer 2013 course from 12/21/13 to 3/22/14.)
Please explain your reason for requesting an exception to the above policy or procedure:
Have you submitted a petition for exception to any academic policy before? Yes No
Reason for previous petition for exception to academic policy:
__________________
Student Signature* Date
*Note: Email approval is acceptable in lieu of a hard signature if provided via an antioch.edu email account.
Santa Barbara, CA 93101
805-962-8179 · Fax: 805-962-4786
Petition for Exception to
Policies and Procedures
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signature
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