Graduate Transfer Credit
Authorization Form
Office of the Registrar
Daniels Hall
100 Institute Road, Worcester, MA 01609
Ph: (508)-831-5211
Fax: (508)-831-5931
Instructions:
Please submit completed form with course description to the appropriate department. All courses must be taken at an
accredited institution. Once the course has been approved, this form will be filed in the Registrar’s Office. After
successful completion of the activity, students should request an official transcript to be sent to the Registrar’s Office
at 100 Institute Road, Worcester, MA 01609. Credit will appear on Banner Web SelfService once it has been posted.
A maximum of one-third of the credit requirements for a graduate degree may be satisfied by courses taken
elsewhere as long as they were not used to fulfill degree requirements at another institution.
Important Information for Interdisciplinary Majors: *Students are required to submit an updated
Program of Study form along with this completed Transfer Credit Authorization Form, indicating the course that is
to be replaced with the transfer credit course. Decisions by the department for approval will not be made without
this information.
Part I: Please Print
Name:
Student
ID:
Major:
Address: City, State, Zip Code
:
Part II: Please Print
Transfer Course Information
Transfer
Course
#
Title_
Credits_
Name
of
College_
Part III:
WPI Course Equivalent and Approval
(To be completed by the Department Head or Graduate
Coordinator)
WPI
Course
#
Title_
or
Elective#
Minimum
Grade
for
Obtaining
Credit
Credit
Department Head Signature
D
ate
Or
Graduate Coordinator Signature Date
Student Signature:_ Date:
click to sign
signature
click to edit
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click to sign
signature
click to edit
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click to sign
signature
click to edit
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