Request for Concurrent Registration

This form is to be used to request permission for an undergraduate student to take graduate level courses.

An undergraduate student who is currently pursuing a baccalaureate degree at Hawai‘i Pacific University may be granted approval to take one or more graduate courses while still an undergraduate. These courses may be used toward a graduate program with certain restrictions (see below). The student must meet the following conditions to be considered for this opportunity:

1. Have 90 earned credits towards his or her declared baccalaureate degree (including current term and transfer credits).

2. Have a cumulative HPU GPA of at least 3.00 on a minimum of 15 earned HPU credits.

3. Individual programs may have additional requirements, please see academic advisor for details.

4. Obtain approval from his or her undergraduate academic advisor and graduate faculty advisor.

5. For clarification of this process, please see your undergraduate academic advisor or graduate faculty advisor. After appropriate approvals, the form will be submitted to the Registrar's Office for processing.

RESTRICTIONS:

1. The student must begin a graduate degree or certificate program at Hawai‘i Pacific University within one year of completing his or her undergraduate degree in order for credits to apply toward a graduate degree.

2. A maximum of 12 graduate credits taken as an undergraduate may apply toward the student’s baccalaureate degree AND a master’s degree at HPU.

3. A maximum of 6 graduate credits taken as an undergraduate may apply toward a graduate certificate.

NOTIFICATIONS:

1. Student will be notified after the concurrent approval form is submitted to the Registrar's Office and student has been registered.

Student Name Student Name First Last
HPU Email
HPU Student ID
Must be 9 characters. Currently Entered: 1 characters.
Registration Year/Term

** Please list only terms open for registration.
Official Undergraduate Major
Concentration ( if applicable )
Expected Undergraduate Graduation Term/Year
Have you filed a Petition to Graduate for a bachelor's degree?

Have you filed a Petition to Graduate for a bachelor's degree? Yes No
Intended Graduate Degree/Certificate Program (if applicable)
Graduate Admission Application Submitted? (if applicable)

Graduate Admission Application Submitted? (if applicable) Yes No
Term/Year of graduate application (if applicable)
To be completed only after meeting with your academic advisor.
Undergraduate Advisor Undergraduate Advisor First Last
1. CRN
1. COURSE ALPHA
1. COURSE NUMBER
1. SUBSTITUTED UG COURSE
2. CRN
2. COURSE ALPHA
2. COURSE NUMBER
2. SUBSTITUTED UG COURSE
3. CRN
3. COURSE ALPHA
3. COURSE NUMBER
3. SUBSTITUTED UG COURSE
4. CRN
4. COURSE ALPHA
4. COURSE NUMBER
4. SUBSTITUTED UG COURSE
Required Signature

All of the information given in this application is complete and correct to the best of my knowledge.
Applicant Name Applicant Name First Last
Concurrent Billing / Tuition

Please note, that by registering for courses, all students agree to comply with all requirements for registration and fulfill all financial obligations related to enrollment.

Review the Tuition and Fee Schedule here: https://www.hpu.edu/business-office/fee-schedule.html
Applicant Signature

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
If unable to sign above, please upload an email documenting your approval to submit this form using your HPU email address.

Attach Files
Date Date / MM / DD YYYY
Upload additional documents here:

Attach Files
Undergraduate Advisor Name Undergraduate Advisor Name First Last
Undergraduate Advisor Approval

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Graduate Program Director Graduate Program Director First Last
Graduate Program Director Approval

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Paragraph

Request for Concurrent Registration

Request for Concurrent Registration

To be completed only after meeting with your academic advisor.

Required Signature

Concurrent Billing / Tuition