Departmental Transfer Request

_______________________________________
Department Chairperson's Signature (required)


*Use This Form Only When Necessary To Move Students From One Section To Another Of The Same Course To Balance On Split Classes. This Form Will Not Serve In Place Of A Drop And Add Form.

The department of request for the semester that the following students be transferred:

FROM:

 CRN (5 digit):
Section Number:

TO:

 CRN (5 digit):
Section Number:

DEPARTMENT
Course Number:
Credit Hours:

Please complete form, print and send to Office of Registration and Records, PH 009

STUDENT ID # Student Name
 Last                               First              MI		 STUDENT ID # Student Name
 Last                              First               MI

CC: Academic Dean
                    Academic Department		 Page of Pages