Course Request Application

(for high school program only)

Date: 22nd Jun,2021

Name of Student: LÊ VŨ MINH KHOA Student ID Number: VN-2736

Student Date of Birth: 13rd May, 2006 Enrollment Date: 29th May, 2020

I would like to send this application to request for:

x extending to my course(s)
฀ ฀ taking more than six (6) courses this semester
฀ transferring to the Independent Study program ฀ transferring to Full time/Dual program
Course name Completion (%) Time of Started Date
(for extension course) extension (expected)

US History A 51.4% 1 month 29/06/2021

Reason:
- Due to health issues, so I couldn’t finish the course on time.

Average Hours/Week Attendance this course: ………………………………………………………………..………

Current Overall Grades in semester course(s): …………..……………...Current GPA:…….……..……..………

Student Name and Signature: …………………………………………….…………………………….……………….

confirmed via email

confirmed via email

Parent/Guardian Name and Signature: ……………………………………………….……….……….………………

FIA Approval Name and Signature:

………………………………………………………………….………………….

FVS Academic Department: ฀ Approved ฀ Denied Date: ……....../……....…/………..

FVS Academic Department Name and Signature: .……………………………………………………..

Franklin International Academy CEO Name and

Signature:………………………………………………………………..

BMQT02.05/FMD/AF-032019-V1