Program 60 Request Form

I understand that permission to attend this course is dependent upon the following:

Sufficient space must be available in this section (as of Monday of the second week of the requested quarter).
I must complete all course requirements including exams and regular attendance.

I also understand that by attending this course:

I will not received earned hours
I must request permission from the Program Director(s)
I may not repeat this course or an equivalent for a grade at a later date.
I may not take the EM exam for this course at a later date.

Please submit this form no later than the 1st week of the quarter that you wish to attend a Portuguese course.

First Name:
Last Name:
E-mail Address:

Indicate the quarter in which you are requesting to attend a class.

Choose quarter Autumn
Winter
Spring
Summer

Indicate the course you would like to attend.

List any Portuguese courses you have taken here at The Ohio State University or at another institution.
Any Portuguese courses taken

Indicate the time(s) you would like to attend the course

Call Number:

Provide the last course taken, quarter of attendance, final grade, and the name of your instructor.
Last Portuguese course taken, quarter, final grade, and name of instructor.

State your reasons for requesting to attend this class.
Reasons for this request.

Who referred you to this department for possible course attendance?