Office of Records and Registration
640 Bay Road, Queensbury, NY 12804-1445
CALL: 518.743.2279 | FAX: 518.832.7601 | EMAIL: registrar@sunyacc.edu
Transfer Credit Pre-Approval Form
A Course description of the requested course(s) listed below must be submitted with this form.
Course(s) must be taken at a regionally accredited institution of higher education.
No more than 34 degree credit hours or 15 certificate hours may be granted as transfer credit for work completed in all of
these programs combined.
Course(s) must be taken for a letter grade, and transfer credit can only be awarded to courses completed with a grade of
“C” or higher.
All transfer credits applied to the student’s record will appear with a grade of “T” (Transfer).
Name (Please print): ____________________________________________________ Banner ID: _________________________
Email Address: ________________________________________________________ Major: _____________________________
My signature below indicates I understand the transfer credit requirements noted above. I understand only approved transfer credit and
courses with a grade of C or better will be applied to my student record.
Student Signature: _____________________________________________________ Date: _____________________
Requested Course One:
College/University: __________________________________________________ Semester/Year: ___________________
Subject: ______________ Course Number: _____________ Title: _____________________________________ Credits: _______
REGISTRAR OFFICE USE ONLY:
SUNY Adirondack Equivalency: __________________ Decision: ❑ Approve ❑ Deny (see comments for further information)
Comments: ______________________________________________________________________________________________
Requested Course Two:
College/University: __________________________________________________ Semester/Year: ___________________
Subject: ______________ Course Number: _____________ Title: _____________________________________ Credits: _______
REGISTRAR OFFICE USE ONLY:
SUNY Adirondack Equivalency: __________________ Decision: ❑ Approve ❑ Deny (see comments for further information)
Comments: ______________________________________________________________________________________________
Requested Course Three:
College/University: __________________________________________________ Semester/Year: ___________________
Subject: ______________ Course Number: _____________ Title: _____________________________________ Credits: _______
REGISTRAR OFFICE USE ONLY:
SUNY Adirondack Equivalency: __________________ Decision: ❑ Approve ❑ Deny (see comments for further information)
Comments: ______________________________________________________________________________________________
For Registrar’s Office Use ONLY:
Registrar Staff Signature: ___________________________________________________ Date: ______________________
❑ Copy sent to Student
Updated: 4/3/2020
click to sign
signature
click to edit
![]()
