REQUEST FOR WAIVER OF THE BYLAWS

COLLEGE OR UNIT:                        QUEENS                          DATE:    _____________________

The individual named below does not meet the requirements specified in the bylaws of the Board of Higher Education.  The following information is presented in compliance with the bylaw requirement, that the president when requesting a waiver of the bylaws, shall submit a full written report setting forth why the application of the bylaws is not possible or advisable, and specifying clearly the qualifications of the candidate which can be reasonably accepted within the spirit of the requirement.

COMPLETE THE FOLLOWING:

Annual

Department & Title Name Period Salary Rate

Drama, Theatre and Dance       John Doe                      9/1/04 – 1/31/05             $

Adjunct Lecturer

PERSONAL DATA: (see attached curriculum vitae)

SPECIFIC REQUIREMENTS FOR WHICH WAIVER IS REQUESTED: (e.g. Lack of Ph.D., Baccalaureate, years of experience,

etc.  Include bylaw Article and Section):

Lack of Baccalaureate Degree

WAIVER REQUESTED FOR PERIOD OF :         1 Yr._____ 2 Yrs.______   __________

WAIVER REQUESTED FOR:  Appointment___;Promotion____:Reappointment with Tenure_____:

REASON FOR WAIVER:(use additional pages if necessary)

I hereby certify that this request for a waiver of the bylaws is for the good of the institution.

(One copy only to be sent to the Office of the Secretary).                           _______________________________

                    President

(Waiver Number_______since Sept._________

Oct. 1971