Fillable Postbac Certificate FORM15-Certificate.pages

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Postbac Certificate FORM15-Certificate.pages

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Updated 12/2018
Saint Louis University
Petition for
Post-Baccalaureate Certificate Admission
Form
#15
Enrollment Services Center - DuBourg Hall, Room 119
1 Grand Blvd. St. Louis, MO 63103 314.977.2269 www.slu.edu/questions
Section 1
Student
Student Name
Student Email
Primary Program
Student ID
Student Phone #
Section 2
Certificate Request
Student Signature
Date
I am requesting admission into the following post-baccalaureate certificate in
addition to the above listed primary program.
I understand and acknowledge that:
Section 3
Approval
Director/Chair Name Signature
Date
Primary Program Approval
Section 4
Approval
Director/Chair Name Signature
Date
Certificate Program Approval
Requested Post-Baccalaureate Certificate:
✴ Credits taken in the requested post-baccalaureate certificate may or may not satisfy the
course requirements of my primary program.
Form Procedures
1. Student completes sections 1 and 2.
2. Student receives approval from primary program Director/Chair via signature in section 3.
3. Student receives approval from certificate program Director/Chair via signature in section 4.
4. Certificate representative submits approved Petition for Post-Baccalaureate Certificate Admission
to the Office of the University Registrar.
5. Office of the University Registrar records the approved course on the student’s record.
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Completed 19 March 2020

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