Tennessee Tech | Jere Whitson Building, Room 221 | tntech.edu/records/graduation
ACADEMIC SERVICES
TENNESSEE TECH
Student Name: _____________________________________________ T#: __________________ Term: _________
(Last) (First) (MI)
Student Email
: _____________________________________________________________________________________
Major: __________________________________ Class: _______________ Graduation Date: _____________
Course(s) to be taken by extension or in-residence at: ________________________________________________
(Name of Institution)
This form should be filed by any student desiring to enroll for extension work or in-residence work at another institution
with the intention of transferring the credit to Tennessee Tech. Official transcripts of such study should be furnished
immediately upon completion of work. See the Catalog and Student Handbook for residence requirements for graduation
and for regulations concerning courses. Submit this form to the Graduation Office, Jere Whitson 315, after you have
obtained the necessary signatures below.
TRANSFER WORK WILL BE AWARDED IF FROM A REGIONALLY ACCREDITED INSTITUTION.
Disc.
Course
No.
Course Title
Sem.
Hrs.
Online
Course?
(Yes or No)
No. & Title of TTU equivalent
course
Dates of Proposed
Study
(Beginning & End)
Cr. Load at
TTU during
this period
-
-
-
I understand that approval of this request is effective only for the period indicated above.
Student Signature: ___________________________________________ Date: ___________________
Approval Signatures:
Advisor: _________________________________________________________ Date: ___________________
Chairperson of the Department in
which the work is offered on campus: ____________________________________ Date: ___________________
Dean of School or College in which enrolled: ______________________________ Date: ___________________
Dean of College of Education
(If working toward teacher certification): _________________________________ Date: ___________________
