THE QUEEN�S UNIVERSITY OF BELFAST

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					                             THE QUEEN’S UNIVERSITY OF BELFAST
                              APPLICATION FOR CREDIT TRANSFER

This Application for CREDIT TRANSFER is for all courses except full-time undergraduate courses.
Please complete in block capitals using black ink.

PLEASE PHOTOCOPY THIS FORM IF YOU                          Single Application                    Yes     (Please circle)
ARE APPLYING FOR CREDIT FROM MORE                          Additional application(s)             Yes
THAN ONE COURSE.



                                              PERSONAL DETAILS
                                       Please use BLOCK CAPITALS


Surname _______________________________                   Forenames _____________________________
(Mr/Mrs/Miss/Ms)                                          (in full)


Previous Surname ________________________                 UCAS Number ___________________________
(if applicable)                                           (if appropriate)
Date of Birth _____________________________               QUB Student No. _________________________
                                                          (if previously a student at this university)


Address for correspondence ___________________________________________________________

_______________________________________ Post Code ________ Tel No (home): ____________

Tel No (work): ________________ Mobile: ____________________ Email: _____________________



1. TITLE OF THE COURSE FOR WHICH YOU
   ARE CLAIMING CREDIT (eg. Postgraduate Diploma in ...) _________________________________

2. QUB COURSE
    (ie. the course for which you are seeking credit transfer to) ___________________________________________

    School/Institute/College ____________________________________________________________

3. DETAILS OF THE COURSE FOR WHICH YOU ARE SEEKING TO CLAIM CREDIT
     Type of course (please circle)          Taught           Research


                                             Other (please State) ________________________________________

    Proposed date of admission to Queen’s _______________________________________________


OFFICE USE ONLY                   INITIALS      DATE           DECISION                                   MISCD
                                                               (level & CATS points awarded
Admissions Tutor/Selector

Director (School/Institute)

Dean

Admissions Officer

Student Records Officer
4. (a) AWARDING BODY and/or                    (a) ……………………………………………………………..

     (b) INSTITUTION AT WHICH COURSE           (b) ……………………………………………………………..
         STUDIED

5. LIST COURSE MODULE/UNITS/ FOR WHICH YOU ARE CLAIMING CREDIT, ADD TEACHING
   HOURS, COMPLETION DATE, CATS LEVEL AND POINTS IF KNOWN AFTER EACH MODULE.
   (N/A if not applicable)

Course Module/Unit                                     Teaching    Completion or Expected       CATS Level
                                                       Hours       Completion Date              and Points
1
2
3
4
5
6
7
8
9
10
11
12
13

6. HAVE YOU ATTTACHED A SYLLABUS       Yes    No    if No please give reason
   INCLUDING OUTLINE OF EACH COURSE ..………………………………………………………………
   MODULE/UNIT FOR WHICH YOU ARE
   CLAIMING CREDIT? (please tick) ..……………………………………………………………..
                                                 Please note that this application cannot be processed unless
                                                 syllabus documentation is attached.

7. HAVE YOU ATTACHED CERTIFIED                   Yes              No            If No please give reason:
   TRANSCRIPT OF RESULTS? (please tick)
                                                 ……………………………………………………………….

                                                 ……………………………………………………………….
                                                 Please note that this application cannot be processed unless
                                                 a transcript of results is attached.

8. ARE YOU AWAITING FURTHER                      Yes              expected date ……………………………
   CERTIFICED TRANSCRIPTS?

9. HAVE YOU ATTACHED YOUR FEE?                   Yes              Amount ……………………………………




SIGNATURE _______________________________ DATE _________________________________


                                               NOTES
1. This form must be completed on both sides by applicants who seek transfer of credit for courses or
   course module/units which they have successfully completed at this or another institution.

2. It must be accompanied by syllabuses or course outlines for all module/units for which credit is
   requested together with transcripts of results obtained to date.

3. BEFORE COMPLETING THIS FORM applicants should acquaint themselves with the details of the
   Credit Accumulation and Transfer Scheme. An outline of the scheme is provided in the Guidance
   Notes to Accompany the Application Form which you should already have. This information can also
   be accessed from our website, Postgraduate Taught, Further Information (www.qub.ac.uk/edu). The
   regulations may be found in the University Calendar.

4. The completed form must be submitted at the same time as you submit your course application
   online. Completed forms to be returned to the Postgraduate Administrator, 20 College Green,
   Belfast, BT7 1LN.

				
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