3050 Martin Luther King, Jr. Drive Phone: (318) 670-9229
Shreveport, Louisiana 71107 FAX: (318) 670-6344
www.susla.edu registraroffice@susla.edu
This form is designed for use
by continuing students to secure approval prior to taking courses at another institution. Approval ensures the course(s)
listed below can be used to meet degree requirements at SUSLA. Students must attach a copy of the course description(s) from the institution for transfer
credit and submit the completed form, with all required signatures, to the Registrar’s Office for processing. In order to receive credit, students must
request that an official transcript from the institution for transfer credit is released to SUSLA.
This is to certify that has been granted permission to take the following course(s) at
Student’s Name SUSLA Student I.D. #
Name and Address of College or University
Student’s Contact Information (for notification purposes): Email Address Phone Number ( )
Course No.
Course Name
Hrs.
Course No.
Equivalent at SUSLA
Hrs.
Division Review and Approval
Signature Required
ENGL
101
Freshman English I
3
ENGL
110
English Composition I
3
Student’s Signature Date Advisor’s Signature Date
Division Dean’s Signature Date Vice President for Academic Affairs Signature Date
Year: Term: Fall Spring Summer I
Summer II
Summer III
Records and Registration
Transfer Credit
Request
RO
: Transfer Credit Request Form: 07/14:Revised 07/15:Revised 07/16:07/17:08/19-LR
Date Transcript Received: ______________
Date Transfer Credits Posted: ____________
Processed by: ________________________
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