Department of Psychology
Major Requirement Substitution Form

to be filed in student's docket (in 406 Sch) and entered in student's DAR

Student : Read Instructions then complete top part of this form and bring it, along with syllabus and other course materials, to your Program Advisor*. If permission is granted, it is your responsibility to deliver copies of the signed form to the appropriate offices, including the Undergraduate Curriculum Assistant in 406 Schermerhorn Hall.

Name_______________________________________ Class________________ Date ____________

UNI ______________ other email addr _________________________Declared major when? ______

Campus Address _______________________________________ (phone)___________________

Home Address _________________________________________ (phone)____________________

I am applying to have the course described in the box below accepted as a substitute for the following CU Psych Dept Course or major/concentration requirement: ________________________________ ____________________________

Number and name of substitute course:________________________________________________________

Taken where? ___________________. Taken when?__________ Grade rec'd____.

How many points of transfer credit were awarded by CC or GS? ________________


I am providing my Program Advisor with the following materials: ___syllabus showing lecture topics and reading assignments; __course description; __transcript; __CC or GS transfer credit report; __textbook; __exams; __papers

I think this substitution is justified because (check all that apply): ( ) The course I took is comparable to one offered in the Columbia Psych Dept; (  ) I have the syllabus and other materials to show this; ( ) I took the course less than 8 years ago; ( ) I took the course before transferring here; ( ) I received a grade of B- or better; ( ) other justifications (use back if necessary):

Program Advisor completes bottom part of form.

This is to certify that, for the student named above, the course described above may be substituted for the following course/requirement in the Dept of Psychology: _________________________________ ____________________ and should count for ________ credits.

If this is a conditional approval, any conditions that must be fulfilled are checked:

__ grade received must be C- or better (for courses taken at Columbia University)
__ grade received must be B- or better (for courses taken elsewhere)
__ approval must be obtained from the following faculty member:
__ the Program Advisor needs to see the following materials:

Approved by ______________________________________________ on (date) ________________

Must be signed by one of the following *Program Advisors: Profs. Hart, Lindemann, Putnam, or Sparrow (CC and GS Psychology Program Advisors) or Profs. Lau and Wager (CC & GS Neuroscience & Behavior Program Advisors)

 

Student: When you print this form, please be sure that it fits on one page. Click here for single page pdf file.

This page is maintained by asj2124 and lep1. It was last modified by asj2124 on July 9, 2009