Permit Request Form

Student Name (first-name last-name) *

CSU ID *

CSU Email Address *

Phone *

Please enter your 10-digit phone number; don't use dashes (-) or periods (.)

Student Type *

Course Number (MTH XXX or STA XXX, please include prefix) *

4-digit Class Number *

Section Number *

Term *

Summer 2023

Fall 2023

Spring 2024

Summer 2024

Reasons for Permit *

Prerequisite Error (Describe error below)

Other (Explain below)

Explanations/Comments *

Requesting Person *

Student

Advisor

Instructor

Additional Information

My advisor told me to fill out this form to request a permit (include name and email below).

Dr. Gold told me to fill out this form to request a permit.

Dr. Fan told me to fill out this form to request a permit.

I have not yet spoken to the instructor, my advisor, Dr. Gold, or Dr. Fan.

As an Advisor, I am requesting entering a permit for this student for this class (include name and email below).

As an Instructor for the course, I am requesting entering a permit for this student for this class (include name and email below).

Advisor/Instructor Name

Advisor/Instructor Email Address

Upload Documents (optional)

Please include any relevant documents such as unofficial transcripts, course descriptions of courses taken outside of CSU, etc. This form will be expedited if the student submits the necessary approval from the advisor.
Files must be less than 2 MB.
Allowed file types: pdf doc docx odt zip.

You will be contacted if there is a problem with your request, and also when your request is completed. Please allow at least two business days to process your request. If your permit is needed before the close of a business day, please contact the Mathematics Department directly at 216-687-4680 to check on its status.

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Cleveland State University

Engaged Learning

Permit Request Form