OVERLOAD REQUEST FORM

Mail to: UNC at Pembroke
              Office of the Registrar
              P.O. Box 1510
              Pembroke, NC 28372
or FAX (after acquiring approval):  910-521-6328
Call for FAX Confirmation:  910-521-6298

Name/Title: __________________________________________UNCP ID: ___________

Address: _______________________________________________________________

I request permission to take ______ hours during the ________________ semester for the

following reasons: ________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Classification (SR/JR/SO/FR):_______________________________________________

Expected Date of Graduation:________________________________________________

Present GPA (to be completed by Registrar’s Office):_______________________________

Verification:_____________________________________________________________
                                        (University Registrar’s  Signature)

I approve this request for an overload:_________________________________________
                                                                        Advisor’s or Department Chair’s Signature

                                                                        _____________________________________
                                                                        Dean’s Signature

Approved: ___________    _________________________________________________
                      Date                                         Vice Chancellor for Enrollment Management

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Received in Registrar’s Office by:_____________________________________________

Date Processed:_________________________________________________________

This publication is available in alternative formats upon request. 
Please contact Disability Support Services, DF Lowry Building, 521-6695.