Updated 5/31/2017

Request for Graduate Student Admission Exception FACULTY USE ONLY

Start Term Semester:

Applicant Information

Name:

LSU ID: Academic Year of Entry:

Departmental Information

The Department of is seeking an exception to admit the applicant named above and seeks to offer the student

Regular Admission

Provisional/Probationary Admission

The reason(s) an exception is needed:

Low undergraduate GPA

Low TOEFL/IELTS/PTE score

No TOEFL/IELTS/PTE score

Provisional Admission

Probationary Admission

Low graduate GPA

Low GRE/GMAT score

No GRE/GMAT score

Previously dropped from the Graduate School

Other (explain below)

The following is required to consider the exception request:

I have attached a detailed justification to this form per the instructions.

I acknowledge that an approval of this exception does not mean ISO will issue an I-20 form.

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Updated 5/31/2017

Signature: Date:

Signature: Date:

Signature: Date:

Approved Denied

Administrative Approval

Faculty Member:

Director of Graduate Studies*:

College Dean:

Graduate School Dean:

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*If the department does not have a Director of Graduate Studies, the Graduate Advisor should sign instead.