UNIVERSITY COLLEGE DUBLIN Internal Credit Transfer – CAO Applicants Application Form Module and credit transfer information This application form is for students who previously completed part of a programme in UCD - without finishing the programme who have then transferred to another UCD programme through the CAO. As part of the transfer process all modules previously completed at UCD that are directly applicable to the new programme of study will be applied to the new programme (including transfer of credits and grades). Where modules are not directly applicable to the new programme of study, applicants may request the transfer of modules, credits and grades to the new programme of study. Before completing this form please note: It is only necessary to complete this form if you have entered a new UCD programme via the CAO and wish to transfer credit achieved for UCD modules on a previous programme. If you are applying for credit transfer for learning which you completed on a modular programme at UCD, please complete sections A and B; alternatively f you are applying for credit transfer for learning which you completed on a pre-modular programme please complete sections A and C. Please ensure you read the Programme Transfer: Internal and External Applicants Policy and Procedures (http://www.ucd.ie/registry/academicsecretariat/docs/transfer_po.pdf) before completing this form. If you would like any further information please contact your Programme Office or Assessment, UCD Registry. Contact details for Programme Offices can be found at http://www.ucd.ie/programmeoffices.htm and Assessment, UCD Registry can be emailed at assessment@ucd.ie. Submission deadline Please return this completed form to Admissions, UCD Registry, Tierney Building no later than 1s November of the year that you enter the new programme. A. PERSONAL DETAILS (required from all applicants) Programme information requested in this section refers to the new programme that you have entered through the CAO. Student Name Email Address Programme Title Programme Start Date Student No. Phone number Programme Code Stage STUDENT SIGNATURE to verify that you have read and understood the Programme Transfer: Internal and External Applicants Policy and Procedure and that all the information supplied is correct to the best of your knowledge, please enter your signature in the box below. Signature: Date: 1 B. APPLICATION FOR ACCREDITATION: MODULAR STUDENT If your previous education in UCD was on a modular programme, please provide the following information for each module for which you are requesting accreditation. Please note that the module credit and grade will be transferred onto your new programme of study where your application is successful. Please use an additional page appended to this form, if you are applying for the transfer of more than 4 modules into your new programme MODULE 1: TITLE Code: Module 1: Code and Final Grade awarded Final Grade: Module 1: Course Reference Number (CRN) *1 Credit value of module Stage of new programme, to which the credit should be applied MODULE 2: TITLE Code: Module 2: Code and Final Grade awarded Final Grade: Module 2: Course Reference Number (CRN) Credit value of module Stage of new programme, to which the credit should be applied MODULE 3: TITLE Code: Module 3: Code and Final Grade awarded Final Grade: Module 3: Course Reference Number (CRN) Credit value of module Stage of new programme, to which the credit should be applied MODULE 4: TITLE Code: Module 4: Code and Final Grade awarded Final Grade: Module 4: Course Reference Number (CRN) Credit value of module Stage of new programme, to which the credit should be applied 1 * Please note: The CRN of each module is listed under your “Examination Results” in the “Student Records” section of your UCD SIS web account. Your SIS web account can be accessed through the “Student Life” Tab on your UCD Connect student account. 2 C. APPLICATION FOR ACCREDITATION: PRE-MODULAR STUDENT If your previous education in UCD was on a pre-modular programme, please provide the result that you gained in each subject for every year that you completed in UCD and for which you are applying for credit transfer. YEAR 1 Subject 1 Result Subject 2 Result (if applicable) Subject 3 Result (if applicable) YEAR 2 (if applicable) Subject 1 Result Subject 2 Result (if applicable) YEAR 3 (if applicable) Subject 1 Result Subject 2 Result (if applicable) YEAR 4 (if applicable) Subject 1 Result Subject 2 Result (if applicable) 3 FOR INTERNAL UCD OFFICE USE ONLY 1. RECEIVED BY ADMISSIONS, UCD REGISTRY Signed: Date: Print name: 2. RECEIVED BY PROGRAMME OFFICE Office: Date: Signed: Print name: 4