Course Extension Request Form

Use this form to request an extension for one of your current courses.

DEADLINES

Length of Course	Extension Request Form Due Date	IF GRANTED: Extension length
16-week course	3 weeks prior to end of course	5 weeks
10-week course	2 weeks prior to end of course	3 weeks
8-week course	1 week prior to end of course	3 weeks
2 or 3-week course	EXTENSIONS NOT PERMITTED	N/A
Other session lengths	2 weeks before the end of regular class meetings	See "Course Extensions" Academic Catalog

POLICIES AND INFORMATION

You must submit one form per course
Each extension request requires a $40 payment.
Late extension requests will incur an additional $10 fee.
Students must have submitted at least 75% of the required coursework for the course requested on this form with no more than 25% remaining
Please note that course extensions are only granted in unusual or rare cases.
Busy schedules or travel plans that conflict with final exam periods are not considered valid reasons for course extensions.
Professor responses must be submitted to the Office of Academic Records prior to the last day of final exams in order to be considered. Decisions will be emailed once the response has been received by the Office of Academic Records from the PROFESSOR.
Refer to the Academic Catalog for your campus for the complete course extension policy.

Course Session 16 Week 7 or 8 Week Other

Please explain below why you were unable to submit this request by the required deadline. Failure to explain will result in the automatic denial of your request.

First Name

Last Name

Student ID Number

Phone Number

Email Address

Signature: By typing your name below, you certify that you are the student and that understand and agree to all the policies above. To proceed and submit this request, you must type your full name below.

Signature

Request extension for course:

Section Number (leave blank if you don't know)

Semester

Instructor Name

This is an aviation course

I have completed at least 75% of the coursework required for this course

What specific course requirements do you have remaining and what is your plan to complete these requirements?

Please select any of the items below that apply: I am requesting an extension for a Music Jury

What is the reason you are requesting an extension? Failure to explain your request and provide relevant documentation, where applicable, may result in the denial of the request.

If needed, please upload any relevant documentation here.

If you wish to call in with your payment information or submit cash, please call 312-329-2087 or drop off cash with the office of Academic Records on Culby 2. Fee waivers are only granted for music juries and for students who have submitted thorough medical documentation.

Forms without associated payment will not be processed.

Credit Card Number

Credit Card Type

Expiration

Name on Card

Billing Address

Course extensions are subject to the approval of each instructor. Once the form is submitted, the request details will be forwarded to . Payment information or fee waivers are handled by the Office of Academic Records.

Signature: By typing your name below, you certify that you are the student and the information on this form is true to the best of your knowledge. If payment information was provided, you authorize Moody Bible Institute to charge the credit card number above for the extension you are requesting. To proceed and submit this request, you must type your full name below.

Signature