DEPARTMENT USE
TCE
USE ONLY
QTR/SEM
CREDITS
COURSE TITLE
STUDENT USE
COURSE NUMBER FLORIDA TECH EQUIVALENT
UNDERGRADUATE REQUEST TO STUDY AT ANOTHER INSTITUTION
Approved (Choose one)
Academic Advisor _________________________________________________________________________ Date ________________________________ YES NO
Print name _________________________________________________________________________________________________________
Department Head / Program Chair __________________________________________________________ Date ________________________________ YES NO
Print name _________________________________________________________________________________________________________
RGR-471-0220
SEND TO: Melbourne Campus Students: tcetech@t.edu DATE ____________________________________________________
Florida Tech Online Students: OL-tce@t.edu
FROM:
_____________________________________________________________________________ _______________________________________________________
Last First Middle Student ID Number
I request approval to enroll in the course or courses listed below for transfer credit to Florida Tech. I understand the grades must be C-
or better for courses to transfer; the grades themselves and GPA will not transfer; and the Forgiveness Policy does not apply.
The request MUST be received and approved by the appropriate oce (see above) prior to registering for the course or courses.
Melbourne campus students must get verication of transferability from the Oce of the Registrar before having the form signed and returned to the
registrar’s oce. A student may take up to three courses at other institutions for transfer to a Florida Tech undergraduate degree program.
Florida Tech Online students sign form, provide course descriptions and email to OL-tce@t.edu, axing only student signature; additional approvals added
by evaluator. All students: Course descriptions must be attached when submitting request. This form does not constitute approval to take course(s) at
another institution. Students will be notied by email from the appropriate oce. Students must request an ocial transcript be mailed from the approved
institution directly to Florida Tech. Hand-carried transcripts are not considered to be ocial.
MELBOURNE CAMPUS ADVISOR: Please initial one
o The course or courses requested are not oered through Florida Tech Online during Summer1 or Summer–2.
o The course or courses requested would be more advantageous to the student in a classroom format.
OFFICE USE ONLY: Institution code
_______________________
Term I plan to attend ______________________________________
Institution’s name __________________________________________________________________________________________________________________
Please Answer: Are you an international student? o Yes o No
International Student and Scholar Services
_________________________________________________  Date _____________________________________________
Print name ________________________________________________________________________________________________________
Please Answer: Are you receiving VA benets? o Ye s o No
VA Certifying Ocial
_____________________________________________________________________  Date _____________________________________________
Print name ________________________________________________________________________________________________________
Did you petition to graduate? o Yes o No If yes, for which term ______________________________________________
Student Signature  _____________________________________________________________________
Florida Institute of Technology § Oce of the Registrar § 150 West University Boulevard, Melbourne, FL 32901-6975 § 321-674-8115 § Fax 321-674-7827
DISTRIBUTION:
Original—Registrar
Fax—Florida Tech Online
Copy—Academic Unit