Petition Form
Student Information
Student ID
*
Number ID
Student Email
*
example@example.com
Title
*
Mr.
Mrs.
Ms.
Student Name
*
Degree
*
Undergraduate
Masters
Doctoral
Contact Number
*
Program
*
Artificial Intelligence and Computer Engineering
Artificial Intelligence Innovation
Electrical and Computer Engineering
Technology and Creative Innovation
Current Semester
*
Fall
Spring
Summer
Year
*
Petition Details
Please write you petition summary and details in the section below:
*
0/150
Student Signature
*
Date
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Preview PDF
Submit
Should be Empty: