REQUEST FOR TRANSCRIPT EVALUATION
All official transcripts must be on file in Admissions & Records before this request can be submitted.
Date of Request: Student ID#:
Name (Last, First, Middle):
Former Names:
Phone #: Email Address: @insite.4cd.edu
List previous colleges or universities from which you wish to transfer credits (including high school & AP, if applicable).
IMPORTANT: Do not submit evaluation requests until all official transcripts have been received.
1. 4.
2. 5.
3. 6.
MAJOR OTHER MAJORS
Liberal Arts: Arts & Humanities 1.
Liberal Arts: Behavioral & Social Sciences
Liberal Arts: Math & Science
Current Catalog Year: Other
(Specify Academic Year):
OTHER
Are you a Veteran Student? YES NO
STUDENT SIGNATURE DATE
A copy of the evaluation will be emailed to the student’s InSite Email Account. The student is able to verify on InSite
WebAdvisor if A&R has received their official transcripts.
Counseling Appointment Scheduled:
Catalog Year Approved By A&R:
RE-EVALUATION
Re-evaluate transfer courses.
Re-evaluate for a new declared major.
Re-evaluate additional college transcripts.
Re-evaluate for specific courses.
GENERAL EDUCATION PATTERN/CERTIFICATE (Select all that apply)
Associate of Arts/Science For Transfer (AA-T/AS-T) California State University (CSU)
Associate of Arts/Associate of Science
(AA/AS)
Intersegmental Gen. Edu. Transfer Curriculum
(IGETC)
Certificate of Achievement
(CA)
