IUPUI Office of the Registrar - Permission to Audit a Course

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

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: 317-278-2240
Mail to: Office of the Registrar Cavanaugh Hall, Room 111 425 University Boulevard Indianapolis, Indiana 46202-5143		Visit us at : Office of the Registrar Campus Center, Suite 250 420 University Boulevard Indianapolis, Indiana 46202-5144