H:\Appeal of Transfer Credit.docx 11/21/13
Date_________________________
Student ID: ___________________
Program: ____________________
Appeal of Transfer Credit
Instructions: This form is to appeal the decision made for denied credits. Appeal forms should be filed as soon as possible
after your first attempt of transfer credits. Appeals must be written clearly and include all supporting documents (all relevant
information to verify and support your appeal). If appropriate documents are missing, the appeal is returned. Submit the
completed form to the Office of Records and Registration. Allow up to 3 weeks for this appeal to be processed from the
date it was received. Student will be notified by mail whether the appeal was approved or denied. Use only one appeal
request per form. If a student is not satisfied with the transfer appeal decision the student may appeal the Anoka
Technical College appeal decision at the system level to the Vice Chancellor of Academic and Student Affairs. The
decision of the Vice Chancellor is binding.
Student Information (print clearly):
Name: ___________________________________________________________________________________
Last First Middle
Address: __________________________________________ College E-Mail: __________________________
Appeal Request:
I petition for an exception to the decision made for denying credits from the following Institution:
(Attach all relevant documentation that would verify or support your petition):
Name of Institution: __________________________________________________________________
Reason for Appeal:
Note: supporting documents are not returned
Decision: (Allow 10 – 15 business days for evaluation) could be longer during peak times.
Faculty Recommendation: Approved Denied Date: _________________________________
Faculty Signature _____________________________________________________________________
Academic Dean Recommendation: Approved Denied Date: ___________________________
Academic Dean Signature_______________________________________________________________
Comments:
Submit form via email to: Registrar@anokatech.edu or fax to 763-576-7701 or mail to: Office of Records & Registration, Anoka Technical
College, 1355 West Highway 10, Anoka, MN 55303
