Use this form to submit an outside course petition to the Undergraduate Programs Office.

Be as specific as possible so that we may process your request efficiently.

You may attach a single document pertaining to your request.

An asterisk (*) denotes a required field.

Personal Informaton
*First Name:
*Last Name:
*Suffolk ID:
*Suffolk Email:
*Phone:	- -
Outside Course Information
*Institution:
*Course Name:
*Course URL:
*Course No.:
*Credits:
*Course Start:	JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 12345678910111213141516171819202122232425262728293031 201320142015
*Description:
Attachment:
Reason for Request
*Details: