PREREQUISITE  WAIVER  

 
Division  of  Natural  Sciences  and  Engineering  
Salt  Lake  Community  College  
 
Experience  at  the  college  confirms  that  students  who  have  not  taken  the  required  prerequisites  for  a  class  
have  a  greater  chance  of  failing  or  withdrawing  from  the  course.  We  have  prerequisites  on  classes  so  students  
have  a  better  chance  of  succeeding.    The  intent  of  the  prerequisite  policy  is  to  make  students  successful,  not  
to  slow  the  individual  academic  process  down.  Additionally,  we  recommend  that  with  each  waiver  request,  
you  speak  with  your  program  advisor.    To  receive  consideration  for  a  prerequisite  waiver,  completing  and  
submitting  this  form  is  required.  

 
Student  Name:       Course:    
Student  ID:       Semester:    
Student  Email:       Student  Phone:    
 
 
I  am  requesting  this  waiver  for  the  following  reason(s)  (if  you  need  more  room  please  use  another  sheet  of  paper  or  the  backside  of  this  paper):    
 
 
 
 
 
 
 
I  acknowledge  the  following:    
1.   This  waiver  is  for  the  semester  noted  above  and  will  not  be  given  for  any  subsequent  semester  for  any  reason.    
2.   This  waiver  is  against  the  standard  recommendation  of  the  Division  of  Natural  Sciences  and  Engineering.  
3.   Bringing  forward  this  waiver  releases  the  division  from  any  grievance  that  may  be  brought  forward  
regarding  the  final  grade  in  this  course.    
 
Student  Signature:                 Date:              
 
 
 
 
Instructor  Signature:                 Recommend  Waiver:      o  YES   o  NO  
                         
 
Coordinator  Signature:                 Date:              
 
 
Associate  Dean  Signature:               Date:              
 

  Modified  September  2017