Reverse Transfer Degree Request Supplemental Form

REVERSE TRANSFER DEGREE REQUEST SUPPLEMENTAL FORM

Please complete this online form in its entirety and hit submit, as we cannot consider you for a Reverse Transfer degree without this information.

The Community College of Aurora will consider students for an Associate of Science, Associate of Arts, and Associate of General Studies, and will award the highest degree if all degree requirements have been met.

In order to earn a degree from the community college, students must have earned at least 15 degree applicable credit hours at the Community College of Aurora.

Official transcripts must be mailed directly from the issuing institution(s). “Issued to student”, hand-carried, or faxed transcripts are NOT acceptable.

Once your transcript(s) is received, it becomes part of your permanent educational record.

If you qualify for one of the above mentioned degrees, it will be awarded to you. If you do not qualify for one of the above degrees, you will be notified.

Last Name: *

First Name: *

Middle Name:

Name as you want it to appear on your diploma: *

Previous Name(s) Used:

Student ID at CCA:

Year of Birth: * (4 digit year only please)

Street Address: *

City: *

State: *

Zip: *

Phone Number: *

Metro Email Address:

Student Signature: *

By entering your name in the signature box, you are electronically signing this document and certifying that you are the person indicated. You must enter your real name. If you purposefully enter false or misleading information, you may be denied admission, continued enrollment, or re-enrollment per SBCCOE Board Policy 4-10.

By entering your name in the signature box, you are giving up your permission to make updates to your student record as deemed necessary in order to consider you for Reverse Transfer, including but not limited to awarding of a degree. If you meet the requirements of the degree, you will be awarded the degree.

By providing your email address above, you give us permission to correspond with you at the email address you provided.

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