Student ID#: _________________ Degree/Certificate Program: ________________________ Year of Matriculation:___________
Last Name: _____________________________________ First Name: _____________________________ Middle Initial: ________
CCCC Email Address: ___________________________________________ Phone Number: ________________________________
1. Complete the chart on this form. Identify each course from previous institution to be evaluated for transfer credit, then
identify the course at CCCC that is comparable.
2. Attach a copy of the previous institution’s catalog description for all courses to be evaluated
3. Attach a copy of the syllabus for the course under evaluation if its title and description are not clearly aligned to CCCC
4. Return this completed, signed form and all attachments to the Office of the Registrar.
Institution where credits were earned: _________________________________________________________________________
Course number and title of course from
CCCC comparable course number and title
Student Signature (required): _________________________________________________________ Date: __________________
An updated transfer credit letter will be mailed to you regarding the re-evaluation of any additional transfer credits if
applicable. Please note that transfer credits are only applied to course requirements for a specific degree or certificate
program. Students must complete a minimum of 24 course credits per degree at CCCC.
Office of the Registrar Use Only:
Date Received: ___________________________ Date Entered: ___________________________ Initials: _______________
Office of the Registrar – REQUEST FOR RE-EVALUATION OF
2240 Iyannough Road │ West Barnstable, MA 02668
774.330.4711 │ Fax: 508.375.4084 │ firstname.lastname@example.org │ www.capecod.edu