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Student Name:
RU ID:
Telephone:
Current mailing address:
Sem./Yr. first enrolled at RU:
Sem./Yr. last enrolled at RU:
I request permission to take a challenge examination in:
Department:
Course Title:
Course Number:
Credit Hours:
By signing below I certify that I am a degree-seeking Radford University student and that I am not currently enrolled in this course nor have I previously completed this course:
Student:
Date:
Approval Signatures:
Advisor:
Date:
Department Chairperson (of the course being challenged):
Date:
FEE PAYMENT: Office of Student Accounts -- Walker Hall
Challenge examination fees of $25.00 per credit hour are nonrefundable and apply to the course listed above.
Student Accounts' Cashier's Signature:
INSTRUCTOR APPROVAL: To be filled out by instructor administering examination
Arrangements have been made for the above student to take the above referenced examination. I understand I am to return this form to the Registrar's Office with the section below completed upon completion of the examination.
1. The above student has successfully passed the above examination and should be awarded credit.
2. The above student has not passed the above examination and should not be awarded credit.
Instructor’s Signature:
Date:
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