Form 23 - Schedule Revision Request
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1OFFICE USE
SCHEDULE REVISION REQUEST
OFFICE OF THE REGISTRAR
FORM 23 (11/2013)
PURDUE UNIVERSITY
1. PUID
2. NAME
LAST
FIRST
MIDDLE
Select Term
Choose From List
3.
4. YEAR
5. COLLEGE
6. MAJOR
7.
Office
A-Add
W/
P/
Var.
Instructor Signature
Date
Use
D-Drop M-
CRN
Subject
Course No.
Department Head Signature
Date
Credit
WF
NP
Modify
1
2
3
4
5
6
7
8
AUTHORIZATIONS:
SIGNATURE OF STUDENT
DATE
ADVISOR SIGNATURE
PHONE NO.
DATE
PRINTED NAME
ADVISOR COMMENTS:
BURSAR USE
OFFICE OF THE REGISTRAR COMMENTS:
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Parent category: Business