Application for Letter of Permission (LOP) Course

This form is to be completed when a student wishes to take a course at another institution as part of their program at MDC.

Student Information

Name(Required)

Other Institution Information

NOTE: If you are completing this form for a CASC placement, then please enter the placement site name and contact information for the appropriate person at the placement site with whom MDC can communicate to establish the LOP.

Course Information

Enter the course code for the course being taken at the other institution. Enter NA if this is for a CASC placement.
Enter the course title for the course being taken at the other institution. If it is a CASC placement, enter the name of the placement program.
Enter the course instructor for the course at the other institution. If it is a CASC placement, enter the supervisor's name.
Max. file size: 5 MB.
Upload the syllabus for the course being taken at the other institution. If it is a CASC placement, upload the placement program overview/outline.

Atestations