MEM General Petition Form

MEM General Petition Form

The form must provide all information requested to be considered for approval.

Form Date Field*

First Name*

Last Name*

Cornell Email*

*be sure to include @cornell.edu

Student ID#*

Student Program*

On-campus

Distance learning

Have you been accepted into a Johnson Immersion?*

yes

Which Immersion program?*

Program Advisor*

Select

What type of petition are you requesting*

Requesting to take a course that has not been pre-approved as a program elective. (Must be taken for a letter grade to be considered.)

Requesting to opt out of ENMGT 5930. (Must include the official syllabi and transcript from the related course(s) that you took, which covered the course content. Must be replaced by letter-graded, approved course.)

Opt-out of Python (Distance Learning students only)

Opt-out of Professional Development Workshop to attend second Residential Intensive (Distance Learning students only)

Other

Elective will be taken for a letter grade*

Course Number*

e.g., ENMGT 5900

Course Name*

e.g., Project Management

Course Description*

e.g., The objectives of this course are ...

Please explain the rationale for this request.*

Syllabi and Transcript

Please be sure the syllabi includes schedule of topics/activities, graded deliverables, and grading policy/scale.

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Send me a copy of my responses

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