The University of Southern Mississippi
PERMISSION TO TRANSFER CREDIT
Must include unofficial enrollment record
Student Name Student ID
Student Email Student Phone Number
Major(s) USM Cumulative GPA Classification
I request permission to attend during to take the following courses:
(i.e. MAT 1313)
(i.e. MAT 101)
Yes
No
Justification for Request:
Use space below for all courses requested
If "Yes" was checked under GEC Course, please attach course description and course syllabus with the request.
This step is not necessary if the course is already a part of the Articulation Agreement between Southern Miss and Mississippi Community Colleges.
Circle appropriate comments & have student initial in blanks below
Not Enrolled / Enrolled
Yes
Yes
/ No
I certify that I will not be enrolled at USM during this term. (If student will be enrolled at USM, explain above.)
I understand that grades received for these transfer courses WILL NOT have an impact on my USM GPA.
I understand that I must earn at least 21 of the last 30 hours at USM.
**If an exception is needed, an Undergraduate Request for Exception form must be attached and approved by the Provost.
Student Signature
Date
Advisor Signature Date
Department Chair Signature
Date
College Dean Signature Date