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Alternate Course Request Form

Request for alternate course not on the Graduate Courses list and PhD Core Courses list to count towards CPIN course credit.

Occasionally, students may receive permission for a course that is not on the two lists above to be counted toward their CPIN requirement with special approval from the CPIN Committee. Please fill out the form below to submit your request. 
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First Name:
Last Name:
Email:
 
Supervisor's Name:
Department:
Degree Program:
Expected program completion:
Pick date
Completed CPIN requirements to date (incl. distinguished lectures attendances, research day presentations, approved graduate courses completed so far):
Alternate Course Number:
Course Title:
Department Offering Course:
Please explain briefly the reason this course is being requested. How does it relate to your current research? Does the course have a significant neuroscience component?
Is your supervisor in support of you taking this course?
Yes
No
Please upload a copy of the course syllabus in pdf format: