For Office Use Only
Posted By:____________ Date Posted:___________
Undergraduate Request for Transfer Credit
Office of the Registrar
STUDENT INFORMATION
Student ID:
Name:
Last Name
Email:
First Name
Middle Name
Matriculation Term and Year: □ Fall
Phone:
□ Spring □ Summer 20
UNIVERSITY INFORMATION
Institution Attended:
City, State/Province, Country of Institution:
TRANSFER COURSE INFORMATION
Transfer Course Information
Term and
Year Taken
Course information should be entered by the student and must be copied identically from transcript.
Equivalent Rice Course
Permission from the Dean of Undergraduates must be secured in writing
if registering for transfer courses during a semester that the student is enrolled at Rice.
Course Information should be from the Course Catalog.
Subject
Code
Course
Number
Course Title
Quarter or
Semester Hours
Credit
Hours
Grade
Subject
Code
Course
Number
Course Title
Department Transfer Credit
Advisor Approval
List of advisors available at: rice.edu/advising
*Credit hours determined by OTR.
Credit
Hours*
Approval
Printed Name and Campus Extension
□ Quarter
□ Semester
Approval Signature
Date
Printed Name and Campus Extension
□ Quarter
□ Semester
Approval Signature
Date
Printed Name and Campus Extension
□ Quarter
□ Semester
Approval Signature
Date
Printed Name and Campus Extension
□ Quarter
□ Semester
Approval Signature
Date
STUDENT SIGNATURE
Student Signature:
Date:
E-mail [email protected] I Office 713-348-4999 I Fax 713-348-5921 I Office of the Registrar-MS 57
6100 Main St. I Houston, TX 77005 I registrar.rice.edu
Last revised 3/17/2015