Plan Modification Or Internal/faculty Transfer Application Form Page 2

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Internal/Faculty transfer approvals
Courses required by admitting department.
Related class
Related class
Four-digit
Catalog
Lecture (LEC)
Grading basis
Requirement
Subject code
number and
number and
class number
number
section number
(e.g.,
designation
(e.g., CIVE)
LAB section
tutorial (TUT) section
(e.g., 4142)
(e.g., 125)
(e.g., 001)
AUD, DRN)
(e.g., DRNA)
(e.g., 4143/101)
(e.g., 4433/201)
 Admitted to _____________________________________________________________________________________________________________
Academic level (e.g., 2B) _________
Indicate the Undergraduate Calendar regulations to be followed for the requested internal/faculty transfer.
Academic program calendar year (e.g., 2015-2016) ____________________ Academic plan calendar year (e.g., 2015-2016) _____________________
Options/minors/specializations calendar year (e.g., 2015-2016) ____________________
 Refused
 Defer
 Refer to __________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Admitting Officer(s) approval(s)
Name __________________________ Department _____________________ Signature _________________________ Ext. ________ Date ________
Name __________________________ Department _____________________ Signature _________________________ Ext. ________ Date ________
Name __________________________ Department _____________________ Signature _________________________ Ext. ________ Date ________
Co-operative Education and Career Action approval (if applicable)
Name_________________________________ Signature _____________________________________ Ext. _____________ Date _______________
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