Academic Course Plan Instructions

The Academic Course Plan is a required form for all Undergraduate Transfer Scholars when they begin their study at the four-year institution. The Cooke Foundation uses the form to track each scholar’s course work and anticipated graduation date.

This form must be completed and signed by you and your academic advisor. If your institution has a similar form that provides the information required by the Cooke Foundation, that form may be submitted instead of this form.

INSTRUCTIONS TO SCHOLAR

Please list the courses you must take to complete your bachelor’s degree. In the Course Name Description column:

1) List required course titles and other details as available

2) List general requirements in broad terms, such as “required science course”

3) List elective courses by name when known or when unknown simply list as “elective” and number of credits

4) Total the number of credits for each semester/quarter

If your school is on the quarter system or if you need more space, you may attach additional sheets. Please ask your advisor to review, approve, and sign this academic course plan. Submit the form via mail, email, or fax by

November 4, 2016.

Please note that the Cooke Foundation provides funding for each scholar to complete the degree requirements for a single major. If you include additional majors or a minor in your academic course plan, the course plan will not be approved if doing so would require an extension of your graduation date beyond the time needed to complete the degree requirements for a single major. However, the Cooke Foundation can approve an additional major or a minor if a scholar completes those requirements within the original time frame without extending the scholarship and without overloading on coursework.

Please return the form via email, fax or postal mail to:

Undergraduate Transfer Scholarship

Jack Kent Cooke Foundation

44325 Woodridge Parkway

Lansdowne, VA 20176 (571) 209-1766 (fax)

Academic Course Plan

INSTRUCTIONS TO ACADEMIC ADVISOR

Thank you for taking the time to advise the Cooke Scholar. Please work with the scholar to determine the courses needed to complete the scholar’s bachelor’s degree. Once you review the academic course plan indicate your approval by signing the form.

Scholar Name

Last First MI

College/University Major Start Date Graduation Date

mm/yyyy mm/yyyy

NOTE: If you require more than two years (four semesters or six quarters) to complete your degree, you must request a scholarship extension. The completed Academic Course Plan will act as the initial request. Any further changes will require additional paperwork that you may obtain from the Cooke Foundation. Please include any potential summer study semesters in your plan, but please note a separate summer study request must be filed. Extension requests are reviewed and granted on a case-by-case basis.

Step A Transfer credits accepted towards your degree

+

Step B Credits from this college/university needed to graduate

=

Step C Total Credits needed to graduate

Step D Total Credits listed in Academic Course Plan*

*Total credits listed in the Academic Course Plan may exceed the Step B total. If so, please provide a brief explanation.

Step E Minimum number of credits required per semester to be considered full-time by your school

The foundation encourages our scholars to study abroad. If you are planning to go abroad, please indicate the abroad semester on your course plan.

Please check the box if you are interested in study abroad and would like to discuss the opportunity further with your Cooke Adviser.

Scholar: By signing below, I certify that the following academic course plan is a full list of courses I must successfully complete to fulfill the requirements for a bachelor’s degree at my four-year institution.

Scholar Signature Date

Advisor: By signing below, I certify that the following academic course plan is a full list of courses that the scholar named above must successfully complete to fulfill the requirements for the scholar’s degree at this institution.

Advisor’s Signature Date

Advisor’s Name Position (please print)

Advisor’s Phone Advisor’s Email

Please begin with your first semester/term at your undergraduate institution.

Semester / (Specify semester here; e.g., fall 2016):
Course Name Description / Course # / Credits / Required? Yes/No (major, general /core course, or elective)
Total Credits
Semester
Course Name Description / Course # / Credits / Required? Yes/No (major, general /core course, or elective)
Total Credits
Semester
Course Name Description / Course # / Credits / Required? Yes/No (major, general /core course, or elective)
Total Credits
Semester
Course Name Description / Course # / Credits / Required? Yes/No (major, general /core course, or elective)
Total Credits

Semester
Course Name Description / Course # / Credits / Required? Yes/No (major, general /core course, or elective)
Total Credits
Semester
Course Name Description / Course # / Credits / Required? Yes/No (major, general /core course, or elective)
Total Credits
Semester
Course Name Description / Course # / Credits / Required? Yes/No (major, general /core course, or elective)
Total Credits
Semester
Course Name Description / Course # / Credits / Required? Yes/No (major, general /core course, or elective)
Total Credits

If you are in a school on the quarter system or if you need more space, you may attach additional sheets.