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Pass/Fail Removal Form

If you wish to remove a course from pass/fail, please fill out the form bellow.

Pass/Fail Removal Form

Last Name*
First Name*
Student ID Number*

example: 2001294
UConn Email*
Course Information
Host Institution*
Host Institution Course Number*
Host Institution Course Name*
Term*
Year*
Signature
Signature*
- by checking this box, I confirm that I would like to remove the course mentioned above from pass/fail
Full Name
Date
MM slash DD slash YYYY
Name
This field is for validation purposes and should be left unchanged.

Phone:	(860) 486-5022
E-mail:	egl@uconn.edu
Address:	Rowe Center for Undergraduate Education, Room 117 368 Fairfield Way U-4207 Storrs, CT 06269 United States of America

Pass/Fail Removal Form

Course Information

Signature