UNIVERSITY OF PITTSBURGH \ FORM INSTRUCTION GUIDE FORM TITLE: GRADE OPTION/AUDIT REQUEST FOR AN UNDERGRADUATE COURSE NUMBER: FORM 0084 PROCEDURE: 09-01-03 ENTER THE FOLLOWING INFORMATION WHERE INDICATED: 1. Social Security Number of Student 2. Check one to indicate student level: Undergraduate or Graduate (Includes First Professional) Level 3. Year the Term Begins 4. Name of Student (Last, First, MI) 5. CRN (5 digit Course Reference Number) replaces what used to be know as the "Alpha Code". This number uniquely identifies a section of a course. 6. Subject Area Abbreviation (Up to 6 characters) 7. Course Number (4 digits) 8. Name of Primary Academic Center in which the student is enrolled 9. Course Title Name of Academic Center offering the course Complete to select a Grade Option only: 10. Check one to select S/N or H/S/U option 11. Signature of Student and Date 12. Signature of Academic Representative of Academic Center offering the course (and instructor (if required) and Date Complete to select an Audit Grade only: 13. Check to select Audit 14. Signature of Student and Date 15. Signature of Advisor (or Instructor, if required) and Date.