Permission to Audit a Course

Department Subject    Catalog Number #

Term Year

Student Name
10 Digit University I.D. #

I request permission to attend this course on an audit basis.

I understand that I will receive no credit (NC grade) for this course.
I understand that the course will not apply toward my degree or toward full or part-time enrollment status at IUPUI.
I understand that I will not be able to change back to credit status once this completed form has been filed with the Office of the Registrar.
I understand that I will be charged the regular standard fee rates for this course.
I understand that the appropriate audit fees for this course will be electronically billed from QuikPAY (QP) and a notice sent to my IU email address.

______________________________________
Student Signature
I agree to let the above named student attend my course on an audit basis.
_____________________________________
Instructor Signature
NOTE: Some schools may require additional authorization from Student Advisor and/or Student Dean. Check with your School.

Printing and Delivery - We ask that you type your information on the form and then print it. Audit forms must be filed with the Office of the Registrar (Campus Center, Suite 250) by the deadline published in the academic calendar. Forms received after the deadline will not be accepted.
Office Use Only - Date Received in the Office of the Registrar _____________________________________
Fax to: 317-274-8920

Mail to/Visit us at :
Office of the Registrar
Campus Center, Suite 250
420 University Boulevard
Indianapolis, Indiana 46202-5144


Copyright - The Trustees of Indiana University