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

S.S. No.:___________________________________Phone ___________________________                      

Address:_________________________City ______________ Zip Code ________                      

PROGRAM: BCLAD Single Subject     Major:________________                 

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I am an applicant to the BCLAD Single 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_______.  
_____PLC 400 Secondary School & Bil Ed. - via:________Semester______Grade_______.                  
_____ED 451 Introduction to Multicultural Ed. - via:_______Semester______Grade_______.                      
_____LING420 Linguistics & English        - via:_______Semester______Grade_______.    
                      
_____Other:_______________via:__________.       
_____Other:_______________via:__________      
_____Other:_______________via:__________                    
                    
It is my understanding that the PLC Admissions and Retention Committee will be       
reviewing the attached documentation for:                      

*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____________                      
8-11-99