Transfer Credit Approval Form printable pdf download

Transfer Credit Approval Form

For Transfer Terms and Exchange Programs

Student Information

– to be completed by student

Name__________________________________________________________________ ID__________________ Class_______________

Email __________________________________________________________________________________________________________

By initialing each topic and signing below, I indicate that I understand the following:

______ An exchange/transfer term is not a Dartmouth‐sponsored program. I am therefore responsible for identifying the program and seeking approval for transfer.

______ I am responsible for understanding the regulations for transfer/exchange terms, as stated in the ORC, and the responsibilities required to be awarded credit.

______ There are (3) distinct steps in having a transfer term approved: review by faculty member (which is NOT final approval to transfer the courses), review by

Registrar (includes eligibility of transfer), and approval of the program by COI. The Registrar or the COI may deny approval for courses that do not meet College

transfer requirements, even if they were reviewed and accepted for transfer by Faculty.

Final approval or denial of the transfer term is made by the Faculty Committee on Instruction (COI) and is dependent upon many factors, including the academic

rationale as well as course approvals.

______ Dartmouth will charge me a non‐refundable, non‐pe

onable applica on fee of $2,200 for a winter, spring, or summer transfer term; I will not be charged for an

oﬃcial Dartmouth exchange program. I will pay any addi onal charges directly to the sponsoring program.

______ I will not receive institutional financial aid from Dartmouth College for a transfer term; aid is available for exchange programs.

______ Dates for other school’s payments may not line up with Dartmouth transfer term deadlines; therefore if I elect to par cipate in another ins tu on’s program I

may need to make a deposit, and risk losing it, before I am no ﬁed of the outcome of my transfer term applica on.

______ I am responsible for making all arrangements, financial and otherwise, directly with the transfer term institution.

________ My parents/guardians and I are encouraged to consider the safety and security of the program I am attending. Dartmouth encourages students to register their

itinerary and contact information in the Dartmouth Travel Registry at

by the Provost's Office.

______ Dartmouth does not support travel to countries that are under U.S. State Department warnings. If I am considering traveling to

one of these countries, I must seek a Travel Waiver from the Provost's Office. For more information see

______ Dartmouth encourages students to view the (3) videos for travelers prepared by Dartmouth’s Dickey Center for International Understanding: "Travel Safety,"

"Health and Wellness," and "Emergency Support." I may view them at

______ I am subject to the rules and regulations of the transfer term or exchange program that I attend.

______ I am responsible for supplying the Registrar's Office with an official, unopened transcript sent by the institution after completion of my transfer/exchange term.

______ I will inform whomever is responsible for payment of the application fee, upon signing below. In addition, a letter explaining transfer terms will be sent by the

Registrar's office to whomever is responsible for my bill at my current billing address listed in BannerStudent.

_____________________________________________________________________ ____________________

Student Signature Date

Institution Information – to be completed by student

Institution _______________________________________________________________

in ____________________________

(City and state/country)

Total number of credits requesting to transfer to Dartmouth

____________________________________

Circle one: Transfer term or exchange term

Term (e.g. 13X)

________________________