Credit Evaluation Appeals Form

Student Information

Student First Name:

Student Last Name:

UCID (M#):

UC Email:

Home College:

Academic Advisor Name:

Academic Advisor's Email:

Have you consulted your academic advisor prior to submitting this form?

Yes

Course Information

Please provide additional information related to the course in question. If the student has additional information for credit appeal (e.g. Syllabus, Course Description), please attach the document in the space provided below. Please be reminded that block credit will only be reconsidered when additional information pertaining to the course (e.g. course syllabus) is provided with the appeal.

External Institution Name

Please enter the full name of the external institution (ex: Northern Kentucky University). Abbreviations (ex: NKU) will not be accepted for credit appeal review.

Course Subject Code

Course Catalog Number

Course Title

Course format (select all that apply):

Lecture

Lab

Recitation

Other...

Textbook Information (optional):

File Upload - Transcripts

Please use this field to upload any additional documentation provided by the student (ex: syllabus).

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Requested UC Course

Please provide rationale for appeal:

Credit Evaluation Appeal Form

Student Information

Course Information

iFrame Code