Fields marked with * are required.
This student has permission to enroll in the above class, we have discussed the time conflict.
Instructor Signature: __________________________________
By submitting this enrollment request, I acknowledge that I am enrolling in two classes with a time conflict. I understand it is my responsibility to satisfy all the requirements of both classes.
Student Signature: __________________________________ Date: _________________________________
Submit this form to the Office of Student Services, B01 W. Sibley Hall.