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Student Name
Current Address
City, State, Zip Code
Current Phone Number

Senate Committee on Undergraduate Education*
101 Kern Building
University Park, PA 16802

Dear Chairperson:

(Paragraph one should state the requested action, for example, a retroactive withdrawal from Spring semester, 2003).

(Paragraph two should describe the conditions that warrant an exception and the reason that University policies and procedures could not be followed).

(Paragraph three should include a concluding statement and a thank you).


Student Name (do not forget to sign your letter)
Student Number

*Or Committee on Admissions, Records, Scheduling and Student Aid (for NDEGC students requesting to exceed credit limit).