Internal Transfer Form (All Taught Students)
Academic Registry
Student Office
This form should be used to request a transfer to a different programme. Once completed and signed by the relevant individuals, this form should be returned to your School/Department who will forward a copy to the Student Office.
Part 1 – To be completed by the Student / Current School or Department:
1. Student Name / 2. ID Number
3. School/Department
4. Current Programme / 5. Prog. Code
6. Last Date of Attendance / / / / 7. Current Route – UG Only(e.g. ABCD or ABICD etc.)
8. This is a… / Transfer within School ☐
Transfer to another School ☐
(Please provide name of new School)
9. Student Confirmation I confirm that I understand the financial and, if applicable, immigration implications and request an internal transfer on the basis of the above
Print Name: / Signature: / Date: / / /
10. School Confirmation I confirm that the student has discussed his/her wish to transfer programme with the relevant staff member(s)
Print Name: / Signature: / Date: / / /
Part 2 – To be completed by the Receiving School (for transfers between Schools) or the Current School (for other transfers):
11. New Programme / 12. Programme Code
JACS code: / ATAS required?
Yes ☐ No ☐
13. Start Date / / / / 14. Route – UG Only(e.g. ABCD or ABICD etc.)
15. End Date / / / / 16. Qual. Aim
17. Conditions of Transfer (eg. performance in reassessments):
18. Credit Transfer & Assessment Disregards:
Module Title / Module Code / Attempt
(1 or 2) / C/Work
Mark / Exam
Mark / Transfer /
Disregard
19. School Confirmation (to be completed by the Programme Director)
I am satisfied that the student has met the academic criteria for this transfer and, where appropriate, has completed any prerequisite modules
Print Name: / Signature: / Date: / / /
19.1 School Confirmation (to be completed by the Administrator)
Print Name: / Signature: / Date: / / /
20. Dean of School (or delegated nominee – usually ADT) Confirmation
I confirm that I have discussed the implications of transfer and that due consideration has been given to the student's ability to complete their chosen programme of study.
Print Name: / Signature: / Date: / / /

After completion the signed form should be forwarded to Student Office, Rutland Building.

If the student requiresATAS clearance, please append the relevant certificate.

STUDENT OFFICE USE ONLY
Tier 4 Student (Yes/No) ATAS received? (Yes/No/Not applicable)
Process: Immediately ☐Upon receipt of new visa☐
Once new visa application submitted (Bachelor to Integrated Master only) ☐
Non-Tier 4 student requiring ATAS prior to programme transfer? (Yes/No)
Checked By (Name):

RG1061_INTERNAL_ PROG_TRANSFER V 3.0 Last Updated: January 2017