STUDENT SENIOR SCHEDULE

(for Special Elective Request)

 

 

 

Student’s Name (print)

 

 

Pathway

 

 

 

Please complete to include Scheduled, Pending and Planned rotations

                                                                                                                     

 MUST REPRESENT A COMPLETE 4th YEAR SCHEDULE

 

      

 

Check One

Block or Start

Dates

Course Title

 

 Course
Type
(a,b,
c,d)*

Home
or
Away

 # of weeks

# of
credits

Scheduled

Pending/

Planned/ Not
Scheduled

Example:
Block 1: 7/1/07

PEDS8504S650 Pediatric Sub-I

A H 4

4

X 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
*A=Direct patient care; B=Patient care related; C=Teaching, non-patient care related; D=Research

rev. 1/28/2017