Department Approval Form

Educational Leadership and Counseling
DEPARTMENTAL APPROVAL FORM
(Please print)

STUDENT NAME:

SOCIAL SECURITY NUMBER:

E-MAIL:

STUDENT’S PHONE:

WORK PHONE

WORK FAX

HOME PHONE

HOME FAX

I am seeking to enroll for:

SEMESTER:

YEAR:

COURSE PREFIX & NUMBER:

SECTION:

COURSE CID NUMBER:

COURSE TITLE/SPECIAL TITLE*:

*Special title required if taking ASE/CNE 587.

REQUIRED ASSIGNMENTS (To be completed by professor):

DUE DATE FOR ALL ASSIGNMENTS:

NOTES AND COMMENTS:

Professor's Signature	Student's Signature
Date	Date

Submit CNE 676 form to Dr. Robles-Piña at least one semester before preregistration.
Submit CNE 636 form to Dr. DeTrude at least one semester before preregistration.
Submit all others to the professor teaching the specific course or to the department secretary.