1
08/18
XFER
Undergraduate Permission to Study at
Another Regionally Accredited U.S. Institution
(Not for Registration through the Consortium of Universities of the Washington Metropolitan Area)
Student’s Name: ________________________________________________________________ G#: ______________________
Last First
Mason Email Address: ___________________________________________ Major: _____________________________________
Permission to Study at _____________________________ in ________________________________/________________________
Institution City State
PRIOR APPROVAL IS REQUIRED.
This form must be submitted by the following dates:
o August 1
st
– Fall Semester
o January 2
nd
– Spring Semester
o May 1
st
– Summer Semester
Detailed policy information can be found on page 2 of this form.
This form cannot be used for courses located outside the U.S. See Mason’s Global Education Office for a Petition to the Global
Education Office.
Visited institution must be regionally accredited.
Attach catalog course description and/or syllabus from the visited institution.
Students may not study elsewhere while on academic or non-academic suspension.
Upon course completion, official transcripts from the visited institution must be mailed directly to George Mason University, Office of
the University Registrar, MSN 3D1, 4400 University Drive, Fairfax, VA 22030.
o Credit cannot be transferred until an official transcript is received.
o Students cannot graduate when receipt of the official transcript is still pending.
COURSE ELSEWHERE INFORMATION
Course Subj & Number
(i.e. HIST 100)
Course Title Semester Year
Student’s reason for this request: _______________________________________________________________________________
Student’s Signature: ____________________________________________________________________/_____________________
Date
MASON EQUIVALENT INFORMATION
Course Subj & Number
(i.e. HIST 100)
Course Title
Source of Equivalency:
___current articulation table ___ *course review by department
*Approval for Mason Equivalency (Required for courses NOT on the current articulation table):
____Approved for all students (future articulation table) ____Approved for this student only (explanation must be attached)
____Not approved
Chair/Designee, Department of Course: _____________________________________________/________________
Date
PERMISSION TO STUDY (required for all students):
_____Approval to transfer course back as accepted Mason equivalent
_____Approval to complete College/School Foreign Language requirement
Transfer Credit will NOT be posted. A waiver will appear on the degree evaluation.
Student’s Advisor: ________________________________________________________________/_____________________
Date
Student’s school or college undergraduate academic affairs/
student services office: _____________________________________/_____________________
Date
Undergraduate academic affairs/
student services office for course: _____________________________________/_____________________
Date
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