STUDENT REQUEST FORM
PERSONAL DETAILS OF APPLICANT
STUDENT NUMBER QUALIFICATION NAME
SURNAME INITIALS
STUDY ADDRESS CONTACT DETAILS
Tel. nr. (home)
Tel. nr. (work)
Cell
Code: E-mail
REQUESTED: (Please tick one) √
Additional / excessive Credits
Concurrent registration of modules on different
study periods (where pre-requisites are
applicable)
Concurrent registration for two qualifications
Waiver of prerequisites
Any other request ( mark & indicate below)
MOTIVATION (attach a separate motivation if space provided below is not sufficient)
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Student signature Date
FOR OFFICE USE
RECOMMENTATION: FACULTY ADMINISTRATION
FA to indicate the status of the student record & attach CCL
FA to Indicate whether request supported / not supported
FA to indicate whether request will require consultation with Service Faculty
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Staff signature Date
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APPROVAL: HEAD OF DEPARTMENT
Hod to indicate reason(s) where request is NOT approved
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Staff signature Date
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APPROVAL: FMC (where applicable)
FA to indicate reason(s) where request is NOT approved
FA to indicate outcome of Service Faculty consultation (where applicable)
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Yes / NO /Sign Date
Captured on ITS
Remarks on student record
Student notified
