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Contact Information:
Minnesota State University Moorhead
Registrar’s Office | Owens Hall 210
1104 7
th
Ave S
Moorhead MN 56563
Phone: 218.477.2565
Fax: 218.477.2941
Email: Registrar@mnstate.edu
Minnesota State University is an equal opportunity educator & employer and is a member of the Minnesota State System.
(Completed by Registrar)
Eligibility Verified (16 credits earned with a 2.0 GPA)
Registrar Staff Signature Date
*After obtaining verification and signature, student will be responsible for bringing form and payment to Business Services Office.
(Completed by Faculty Evaluator)
Evaluation
As Faculty Evaluator, I approve an award of:
Credits (enter #) _________
No credit awarded ________
Faculty Evaluator’s Signature
: _________________________________________________Date: __________________________________
*Faculty Evaluator will be responsible for sending form to department chair and dean for signatures.
Section Six (Approval Signatures)
Department Chair Signature: _____________________________________________Date:_______________________________
Dean Signature: _______________________________________________________ Date:_______________________________
*After obtaining signatures, the Dean will forward to the Registrar’s Office.
Section Four (Completed by Business Services Office)
A $35.00 fee per credit is required. You may pay by check or credit card. Make checks payable to Minnesota State University Moorhead
Business Services Staff Signature or Stamp Date
*After obtaining signature and making payment, student will be responsible for bringing form to Faculty Evaluator.
click to sign
signature
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click to sign
signature
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click to sign
signature
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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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