Form Transfer Credit Re-Evaluation Form Student InformationName* First Last PeopleSoft ID#*ex: 1234567 (Non-degree students can enter their NetID)E-mail Address (must be your UConn address unless don't have access to it):* Your major(s):*Student Status*Incoming Freshman or Transfer Student who has been referred via their Transfer Credit ReportCurrent UConn Student who has already had a Prior Course Approval processed (and have been referred)Non-Degree/Visiting StudentThis Transfer Credit eval request is for*a course I am currently enrolled in.a course I have already completed.a Prior Course Approval.Non-Degree/Visiting Student: Do you have any intention of fully matriculating to UConn in the future?*YesNoNon-Degree/Visiting Student: Enter the UConn course you want to enroll in*example: Summer 2020, Hartford, MATH 1131Q-H10SemesterCampusCourse & Section Evaluation InformationEnter the information about the math course you want us to evaluate.College/University*Provide the full name of the institution you completed or will complete the course in which you would like evaluated.Course Number and Title:*ex: MAT 111 Calculus ISubjectCatalog numberCourse Name/Title Semester Taken*Enter the semester/term in which you completed or plan to complete this course:Course instruction type:*In-personOnline/HybridHow were the exams for this online/hybrid course administered?*In-personOnlineWas or is this course instructed outside of the United States?*YesNoHas UConn Admissions already evaluated this course?*YesNoWhat UConn catalog number was assigned to this course by Admissions?*ex: MATH 91101 or MATH 1071Q or RejectedCourse Materials*In order for your transfer credit to be re-evaluated, you must obtain and upload a Syllabus (from or near the term taken) with the following information: instructor information, textbook/course materials, grading, exam information, and course schedule/outline. If this is for an online course, the syllabus must have information about the exam policy/procedure. Drop files here or Accepted file types: jpg, gif, png, pdf, doc, docx. Comments or Questions:CommentsThis field is for validation purposes and should be left unchanged.