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 not receive a grade for this course. I also 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.

______________________________________
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 (133 Cavanaugh Hall) 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:		Hand Carry to:
Office of the Registrar Cavanaugh Hall, Room 111 425 University Boulevard Indianapolis, Indiana 46202-5143		Office of the Registrar Campus Center, Suite 250 420 University Boulevard Indianapolis, Indiana 46202-5144