Transfer Credit Evaluation Form – INSTITUTE OF TRADITIONAL MEDICINE

Please note there are no refunds on Transfer Requests regardless of whether the transfer has been granted. The fee is for the Evaluation of the transfer request.

Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Have you been accepted to an ITM Program? *

Yes
No
Uncertain

Which Program have you requested admission to? *

Which term do you intend to enrol in? *

Fall
Winter
Spring

Please list the course(s) you are requesting to transfer. Include the Name of the Course you have taken and the equivalent ITM Course.

File Upload (Please enclose official transcripts and course syllabi/descriptions from year of enrolment) *

Drag & Drop Files, Choose Files to Upload You can upload up to 10 files.

Additional Information: Please state any additional information you would like to share about your transfer credit request

Declaration *

Agreed

I understand that submission of this form does not automatically secure a transfer of credit to the program. I also understand that there are no refunds for this transfer credit request. I understand that my transfer credit materials will be reviewed based on course contact hours and content. I also acknowledge that transfer credit status does not guarantee that it will take me less than the normal time to complete my program, nor will it necessarily reduce my tuition fees.

Courses (please enter number of courses) *

Price: $56.50

Total

$0.00

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