HUTCHINS SCHOOL OF LIBERAL STUDIES

Sonoma State University

REQUEST FOR WAIVER REVIEW

CHECKLIST FOR REQUIRED DOCUMENTATION

Name: ______________________________ Date: _____________

Permanent Address: _________________________________________________________________(street, city, zip)

Social Security #: _______________________ Phone: ____________

Concentration: _______________________________________________________________________________________

1. Print your name, address, social security number and your phone number in case we need to contact you.

2. It is your responsibility to make sure that a copy of each of the following is in your file:

• a copy of your completed Multiple Subject Major HUTCHINS MAJOR FORM (both sides) from inside the fold over Track II brochure
• a copy of your College Base exam results.
• a copy of your evaluated SSU Major Requirements Form (MRF). You will find the yellow copy attached to your graduation evaluation.
• addendum if there were any changes to the MRF
• Transcripts of all coursework at other institutions should be in your file. A copy of your SSU transcripts will be delivered to the department 4-6 weeks after graduation.
• Clip all of the above together in your file.

3. Place only this completed form in the Waiver Request mailbox in the Hutchins Office at the end of the semester you graduate. Please be sure to refile your advising file in the file cabinet.

4. The Waiver Coordinator will review your file after final grades have arrived (4-6 weeks after graduation), sign the waiver if all requirements have been met, and deliver the waiver on to the SSU Credentials Office for their signature. Once the form is signed by the Credentials Office, copies will be mailed to your requested institution(s) and to you. The approximate completion date for this process is mid-July (or late February).

Institution Name: __________________________________________________________________________________________________________

and address _____________________________________________________________________________________________________________

Institution Name: __________________________________________________________________________________________________________

and address _____________________________________________________________________________________________________________

5. The Hutchins Office will also keep a copy of the Waiver in the office.