Office of Admissions
6/2018 Address: P.O. Box 270 Winnebago, Nebraska 68071 • Phone: 402.878.32380• Website: www.littlepriest.edu
TRANSFER CREDIT REVIEW AND COURSE EQUIVALENCY FORM
Student Name: ___________________________ Student ID #: _________________
College Attended: ______________________________________________________
I would like the following course(s) completed more than 10 years ago to be accepted as transfer
credit at Little Priest Tribal College (LPTC) with their equivalencies.
Course Name & # Term Completed Grade Earned LPTC Equivalent
Department Signature: ____________________________ Date: _______________
Course Name & # Term Completed Grade Earned LPTC Equivalent
Department Signature: ____________________________ Date: _______________
Course Name & # Term Completed Grade Earned LPTC Equivalent
Department Signature: ____________________________ Date: _______________
NON-APPROVAL
The department must indicate approval with a signature next to the course being approved. If a course is not
approved the reason should be described in the space below. Sign, date and return the completed form to the
Registrar’s Office. The Registrar will notify the student of the decision.
Reason for non-approval:
Signature of Department Instructor: __________________________________ Date: ___________________
Date Student Notified: ____________________________
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