Revised 12/10/09 RO Request for Review
REQUEST TO ADD UNIVERSITY OF ALASKA SYSTEM COURSES
UAS, UAF, AND /OR PWSCC
Please Return This Form to One Stop Enrollment Services at the University Center
We evaluate UA System coursework for all University of Alaska Anchorage admitted degree-seeking students
Initial Evaluation: Updated Evaluation:
Name: _____________________________________________________________ UA Student ID#: ________________________
Last First Middle/Maiden
Mailing Address: ___________________________________________________________________________________________
Street/PO Box/Apt City State Zip
Phone: ______________________________________ UA Student Email: _______________________________
(Area Code) (Number)
Semester Admitted: Degree Program: ________________________________
Spring Summer
Fall Yea
r ___________
LIST
SEMES
TERS OF ATTENDENCE:
University of Alaska Fairbanks (UAF):______________________________________________________________
University of Alaska Southeast (UAS):______________________________________________________________
Prince William Sound Community College (PWSCC):__________________________________________________
Student or Academic Advisor Signature: _________________________________________________ Date: _____________
Recommendation: (For Office Use Only)
Approved: _____ Not Approved: _____ Signature: _______________________________________ Date: _____________
Office of the Registrar • PO Box 141629 • Anchorage, AK 99514-1629
• Phone (907) 786-1480 • Fax (907) 786-4888
For Official Use Only
CLICK HERE TO CLEAR FORM BEFORE CLOSING DOCUMENT
Sign and date after printing.
Sign and date after printing.
