RUTGERS-NEW BRUNSWICK - DREW

Graduate Student Cooperative Exchange

1.                  APPROVAL

It is requested that                                                                                                  

(Student’s name - please print)

student ID#                         , a candidate for the degree of                                       

in the                                                         at                                                                      

(name of graduate school)                                                         (name of university)

be permitted to take the graduate course/s listed in Part II, below,

at                                                            during the                                            semester.

(name of HOST university)                                                                   (term/year)

It is confirmed that the student is matriculated, the course or courses are to be counted toward the degree sought, the course or courses are graduate courses by definition, and the course or courses are not available at the student’s university.

   A.  Signed:                                                                                        Signed:                                                              

Adviser sending school                                                                                                             Dean sending school

   B.  The student is admissible to my course:

      Signed:                                                                                           Signed:                                                              

Instructor              Course #                                                                                                      Instructor                     Course #

2.                  GRADE REPORT

                            Course #                                Title                                             Term                     Grade                  Instructor’s Signature

TO: Sending School (Graduate Registrar, Rutgers-New Brunswick or Registrar, Drew University.)

Signed:                                                                                                              

Host School (Graduate Registrar, Rutgers-New Brunswick or Registrar, Drew University)

3.                  DISTRIBUTION

When Part I is completed the form is submitted to the appropriate official at the Host University (Graduate Registrar, Rutgers‑New Brunswick, 65 Davidson Road - Room 207, Piscataway, NJ 08854‑1181, phone 732-445-3557 or Dean, Caspersen School, Drew University, Madison, New Jersey 07940, 973-408-3285).  When both parts are completed the form is forwarded to The Graduate Registrar, Rutgers-New Brunswick or The Registrar, Drew University.