Office of the Registrar

OFFICE OF THE REGISTRAR
THE UNIVERSITY OF NORTH CAROLINA AT PEMBROKE

OVERLOAD REQUEST FORM

Directions: Please print, complete and return to the Office of the Registrar.

TO: The Office of Academic Affairs

Name: ______________________________ Student UID: _______________________

Address: _______________________________________________________________

I request permission to take ______ semester hours in the ________________semester

for the following reasons: __________________________________________________

_______________________________________________________________________

(1) Signed: _________________________ Date: ____________________________

(2) a. I approve this request

for an overload: ___________________________________

(Adviser’s Signature and Date)

b. I do not approve this

Request for an overload: ___________________________________

(Adviser’s Signature and Date)

(3) Classification ___________ (4) Expected Date of Graduation ______________

(5) Are you a transfer student? ___________________________________________

(6) How many semester hours have you replaced for? _________________________

(7) Are you presently a Chancellor’s/Honors List student? _____________________

Present GPA: ________

(To be filled in by the Verification: _________________________

Registrar’s Office) (Registrar)

Action Taken:

Approved Denied _____________________________________________

(Assistant Vice Chancellor for Academic Affairs)

Date: ___________

(Have this petition signed by your adviser and leave it with the Office of the Registrar.)

Please return completed form to:

Office of the Registrar
PO Box 1510
Pembroke, NC 28372-1510

Office Location: Lumbee Hall, Room 133