Graduate Student Transfer Credit Request

Office of Registration and Records

This form should only be submitted by a graduate faculty advisor. Forms submitted by students will not be processed.
Student Name Student Name First Middle Last
Student Brockport Email
About this Form

This Graduate Transfer Credit Request form is intended for external courses that fulfill a required course listed in the student's degree audit under their graduate program requirements.
Student Banner ID
Must be 9 digits. Currently Entered: 3 digits.
STUDENT INFORMATION
Degree level

Degree level Graduate
Purpose for submitting this form is:
Graduate Program
Additional Degre/Program information
Course Information Section
How many external courses?

How many external courses? 1 2 3 4
EXTERNAL COURSE 1
Course 1 Transfer Institution
EXTERNAL Course (1) Subject Code
EXTERNAL Course (1) Number
BROCKPORT EQUIVALENT TO EXTERNAL COURSE 1
Subject Code of BROCKPORT Course (1)

If your subject code is missing from the list, contact the Office of Registration and Records.
Course Number of Brockport Course (1)
EXTERNAL COURSE 2
Course 2 Transfer Institution
EXTERNAL Course (2) Subject Code
EXTERNAL Course (2) Number
BROCKPORT EQUIVALENT TO EXTERNAL COURSE 2
Subject Code of BROCKPORT Course (2)

If your subject code is missing from the list, contact the Office of Registration and Records.
Course Number of Brockport Course (2)
EXTERNAL COURSE 3
Course 3 Transfer Institution
EXTERNAL Course (3) Subject Code
EXTERNAL Course (3) Number
BROCKPORT EQUIVALENT TO EXTERNAL COURSE 3
Subject Code of BROCKPORT Course (3)

If your subject code is missing from the list, contact the Office of Registration and Records.
Course Number of Brockport Course (3)
EXTERNAL COURSE 4
Course 4 Transfer Institution
EXTERNAL Course (4) Subject Code
EXTERNAL Course (4) Number
BROCKPORT EQUIVALENT TO EXTERNAL COURSE 4
Subject Code of BROCKPORT Course (4)

If your subject code is missing from the list, contact the Office of Registration and Records.
Course Number of Brockport Course (4)
ADDITIONAL INFORMATION

Provide added details if necessary
Special Instructions

Enter any information pertaining to this course substitution or waiver.
Graduate Advisor Graduate Advisor First Last
Questions?

Contact registrar@brockport.edu

Graduate Student Transfer Credit Request

This form should only be submitted by a graduate faculty advisor. Forms submitted by students will not be processed.

About this Form

STUDENT INFORMATION

Course Information Section

EXTERNAL COURSE 1

BROCKPORT EQUIVALENT TO EXTERNAL COURSE 1

EXTERNAL COURSE 2

BROCKPORT EQUIVALENT TO EXTERNAL COURSE 2

EXTERNAL COURSE 3

BROCKPORT EQUIVALENT TO EXTERNAL COURSE 3

EXTERNAL COURSE 4

BROCKPORT EQUIVALENT TO EXTERNAL COURSE 4

ADDITIONAL INFORMATION

Questions?