Online Student Affairs Petition Form

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SCS Home > Students > Online Student Affairs Petition Form

Please note, not all student affairs petitions may be filed on line. In cases where additional documentation is required (ie: doctor's note), please complete the standard Student Affairs Petition Form (PDF Format) and follow the directions on the form.

Student Affairs Petition Form

Fields marked with an * are required.

First Name: *

Last Name: *

Address: *

City: *

State: *

ZIP: *

Daytime Phone: *

Evening Phone: *

Email: *

Student ID # *

Your student ID is 7 digits long and it can be found on the front of your wild card.
(Please do NOT enter your social security number)

I am a:

Graduate Student
Undergraduate or PDP student
Student-at-Large

In one or two sentences, state your petition and include relevant term(s), course(s), policies.*
(For example: I petition to apply the Clep exam for American Government to my degree.)

State the reason for this petition.*

Refunds (IF APPLICABLE)

Refunds for course fees are generally non-refundable and any refunds outside of the regular schedule are generally granted only for EXCEPTIONAL situations (e.g. medical issue, immediate family death). These types of refunds also require supporting documentation.

What percentage of a refund are you requesting?

What day did you stop attending class?

For refund schedules visit:

Undergraduates: http://www.northwestern.edu/sfs/scsugrad/tuition.html
Graduates: http://www.tgs.northwestern.edu/financialaid/moreinfo/cancellationsandrefunds/
or: http://www.scs.northwestern.edu/grad/information/tuition.cfm

Reason for refund:

Terms and Conditions:

Statement of Academic Integrity
I certify that to the best of my knowledge all statements by me are correct, complete, and my own. By completing the online student affairs petition form, I agree to abide by the standards of academic integrity expected of Northwestern University students as outlined on the School of Continuing Studies web site: www.scs.northwestern.edu/integrity.

I have read and agree to the above terms and conditions.*

Please enter the 4 numbers pictured above:

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Northwestern University School of Continuing Studies 339 E. Chicago Ave. Chicago, IL 60611 - 3008
Phone: 312-503-6950 (Chicago) 847-491-5611 (Evanston) Fax: 312-503-4942 E-mail:Last updated February 28, 2008 and© 2008 Northwestern University