<p> APPLICATION FOR PASS/FAIL OR AUDIT</p><p>______STUDENT I.D. NUMBER LAST NAME FIRST NAME MID. </p><p>______STREET NUMBER AND NAME CITY STATE ZIP CODE ______DAY TELEPHONE NUMBER EVENING TELEPHONE NUMBER</p><p>IF THIS IS A NEW ADDRESS/ TELEPHONE NUMBER, PLEASE CHECK HERE ______SO THAT WE MAY UPDATE YOUR RECORDS.</p><p>DIVISION: [ ] UNDERGRADUATE (01) HOME CAMPUS: [ ] NEW YORK (1) [ ] GRADUATE (02) [ ] PLEASANTVILLE (2) [ ] WHITE PLAINS (3)</p><p>SEMESTER: [ ] SPRING YEAR: ______[ ] FALL [ ] SUMMER 1 [ ] SUMMER 2 PASS/FAIL (Undergraduate only) A student with 60 credits or more and a cumulative QPA of 2.50 may take one elective course excluding core requirements and major electives per semester for a total of four courses on a Pass/Fail basis. A grade of “P” (passing) will not affect the QPA, however; a grade of “F” (failing) will be computed in the QPA. Students must notify the Office of Student Accounts and Registrar Services of their intent to take a course Pass-Fail within the first two weeks of a fifteen-week term, or the first week of a four, six or seven week session.</p><p>PLEASE NOTE: Once you have elected this option it may not be reversed.</p><p>COURSE REFERENCE COURSE NUMBER SUBJ. NUMBER</p><p>______</p><p>INSTRUCTOR’S NAME: ______</p><p>I elect the PASS/FAIL option in the above course in accordance with the University policy.</p><p>______STUDENT’S SIGNATURE DATE AUDIT Students electing to register on an AUDIT basis pay full tuition and will receive no grade or credit for the course. Graduate students may not AUDIT a degree required course.</p><p>PLEASE NOTE: Once you have elected this option it may not be reversed.</p><p>COURSE REFERENCE COURSE NUMBER SUBJ. NUMBER</p><p>______</p><p>INSTRUCTOR’S NAME: ______</p><p>I elect the AUDIT option in the above course in accordance with the University policy.</p><p>______STUDENT’S SIGNATURE DATE NOTE: These options are not available to non-matriculated or visiting students.</p><p>FOR OFFICE USE ONLY F CRN OPT RB | | | | | | | | | | | ______DATA ENTERED BY/CODED BY DATE</p>