Self-Paced Online Course Extension Request

This form is for current Self-Paced Online Course students only.

If you have not completed your course within the initial enrollment period of nine months, you may receive a one-time, three-month extension for a fee of $10. Requests must be made via this form.

If you have any questions, please contact the Office of Online & Distance Education at 319-273-7206 or gis-program@uni.edu.

Student Information

First Name

Last Name

UID

UNI Email Address

Course Information

Click "Add another response" below to extend multiple courses.

Course

Instructor

Questions and Comments

I understand that I am requesting a three-month extension to my enrollment period and that I will be billed a $10 extension fee. Please contact us at 319-273-2123 or 800-772-1746 if you have any questions.

Contact Information