GTPE Petition Form: revised Spring 2022
Georgia Tech Professional Education
Certificate Program Petition for Exception
Mailing Address: 84 5
th
Street NW, Atlanta, GA 30308
GTID – last 7 digits only (ex: XX123456)
Last Name
First Name
Middle Name/Initial
Email
Phone
Address
Date
Name of Certificate Program:
Course Substitution Information (for a previously completed course)
Title of Course:
Date Completed:
URL to Course Page:
Documentation Required
A transcript or certificate of completion must be submitted
Course Substitution Information (for a yet-to-be completed course)
Title of Course:
Anticipated Completion Date:
URL to Course Page:
Reason for Request:
GTPE INTERNAL USE ONLY
Result (approved; approved w/conditions; denied)
Comments
Date of Action
Unit Admin Name
signature
GTPE Admin Name
signature
