University Extra Credit Authorization Form
Submit and authorize requests for extra credit in university courses. Please complete all required fields to ensure accurate recordkeeping and approval.
Student Full Name
*
First Name
Last Name
Student ID Number
*
Course Name or Code
*
Instructor Name
*
First Name
Last Name
Date of Request
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Extra Credit Request
*
Description of Extra Credit Activity
*
Department or Approving Authority
*
Authorization Decision
*
Approved
Denied
Approver Comments (if any)
Submit Authorization
Should be Empty: