<p> UNIVERSITY OF SOUTHERN INDIANA</p><p>PETITION TO VALIDATE AN EXPIRED GRADUATE COURSE</p><p>PART I: Request for Validation</p><p>Student Name: ______Student ID Number: ______</p><p>Graduate Program: ______Semester/Year Course Taken: ______</p><p>Course to be validated: ______Number of Credit Hours: ______</p><p>Course Title: ______</p><p>Institution (where the course was taken if transferred): ______</p><p>Part II: Validation Mechanism (must be completed in order for a graduate course validation to occur)</p><p>Name of Validator (must be a USI graduate faculty member): ______</p><p>College: ______</p><p>Mechanism to Validate: ______</p><p>If the student is required to perform additional work in order to validate this course, the student work will be completed by this date: ______. If the student is required to complete additional work to validate the course, the parameters of the work should be clearly explained in the “mechanism to validate section.”</p><p>If the student is not required to complete additional work for the purposes of course validation, the reason must be clearly explained above, and evidence that obviates the need for further student work must be attached to this form (e.g., a memorandum from a faculty member attesting to content and </p><p>Revision 7-24-14 rigor similarities in current courses, comparative syllabi of current versus expired courses, etc.). A “Petition to Validate a Transfer or Expired Graduate Course” that does not require additional student work or additional evidence of validation will not be approved.</p><p>Part III: Validation Certification</p><p>I certify that the student listed above has successfully completed all work or provided sufficient evidence to validate his/her knowledge of the course listed above. </p><p>Signature of Validator: ______Date: ______</p><p>Signature of Program Director: ______Date: ______</p><p>Signature of College Dean: ______Date: ______</p><p>Signature of Director of Graduate Studies: ______Date: ______</p><p>Revision 7-24-14</p>