MIDDLE GEORGIA STATE COLLEGE ARTICULATION AGREEMENT VERIFICATION Official Use Only: Approved: Yes ☐ No ☐ Initial:
STUDENT
NAME:
Last First Middle
MSC
ID:
TRANSFER
INSTITUTION
NAME:
DEGREE
COMPLETED
TITLE:
DATE
COMPLETED:
If you’ve completed a degree program at a school that Middle Georgia State College has agreed to an official articulation agreement prior to the date of the official agreement, you will need to complete
this form to receive upper level IT credit.
Please list each IT/CIS/CIST/COMP course subject, number, course title, date the course was completed, First initial and Last name of instructor, and please check the appropriate box to indicate
if the faculty member teaching any course designed for transfer to a baccalaureate degree had either a doctorate or master’s degree in the teaching discipline OR master’s degree with a
concentration in the teaching discipline (a minimum of 18 graduate semester hours in the teaching discipline) at the time the course was taught.
Subject Number Hours Title Date Completed Instructor Name Doctorate Master's degree in IT/MIS/IS/CS
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Total # Hours Instructor YES:
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By signing and submitting this verification form, I certify that information submitted on this and any attached forms is true and correct. I understand that additional information may be required. I understand that completion of this
form does not constitute a guarantee that all courses will be accepted at Middle Georgia State College.
Chair/Dean Name Printed Signature-Chair/Dean (Transfer Institution) Student Signature Date
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