Los Angeles Mission College

Request For Advanced-Course Status

Department: __________________________________________

Department Chair: __________________________________________

(name)

________________________________ _________

(signature) (date)

Course Title and Number

Prerequisite Courses

Prerequisites Validation or Validation Renewal Date

Approved:

Curriculum Chair _________________________________ ____________________

(signature) (date)

Academic Senate _________________________________ ____________________

President (signature) (date)

AFT Chapter ________________________________ ____________________

President (signature) (date)