TO: Policy Studies Department - Admissions and Retention Committee:                  
                  
FROM: Last name____________________________ First name______________________                  

S.S. No.:___________________________________Phone ___________________________                  

Address:_________________________City ______________ Zip Code ________                  

PROGRAM:BCLAD Multiple Subject     Major:________________             

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I am an applicant to the BCLAD Multiple Subject Program and would like to request the following:                   

____1. Course Waiver - Based on equivalent course(s) taken within the last five years. Attach an    
equivalent  course description and grade received.           
               
____2.Waiver of "C-" - If you received a C- in any prerequisite course, you may petition for a "C-    
waiver"  based on same subject prerequisite courses taken.  Grades received must be A or B.          
                  
____3. Course Waiver Based on Previous Experience - Documented experience in the     
classroom (e.g., letter from district or evaluations).                    

Use the above numerical description to specify your type of request (1, 2 or 3):                  

_____PLC 515 Bilingual Teaching Strategies      via:_________Semester____Grade____                
_____ED 451 Introduction to Mul. Education -    via:_________Semester____Grade____                  
_____LING 420 Linguistics and English   -     via:_________Semester____Grade____               
      or __LING 520 Fundamentals of Ling. -    via:_________Semester____Grade____                 
_____LING 452 Child Language Acquisition -     via:_________Semester____Grade____                  
_____LING 550 Theory & Practice of Eng-ESL -  via:_________Semester____Grade____                  
_____ART 100_______101 via:_________Semester____Grade____                 
_____or DRAMA 105    - via:_________Semester____Grade____                
_____or MUSIC 102  -    via:_________Semester____Grade____               
_____or MATH 210A -    via:_________Semester____Grade____               
_____or ENS 241A & B -  via:_________Semester____Grade____                 

It is my understanding that the PLC Admissions and Retention Committee will be reviewing the     
attached documentation:                  

Course Waiver(s): Transcripts and equivalent course description(s).                   
Letter Grade C-: Transcripts to review my academic achievement/history                  
Previous Experience(s): Transcripts and/or documents of my work/academic experience(s).                  
                  
Do not forget to attach the required documentation.  Incomplete petitions (with      
no attachments) will not be considered for review.                  
                 
Signature__________________________  Date____________                  
8-6-99