Reverse Transfer Request and Release Form
University:
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Please Select
Bowie State University
Towson University
Salisbury University
Other
If other, list university here:
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Program of study at CSM:
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If another degree is more suitable, do you grant us permission to change your program and graduate you in that program?
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Yes
No
University Student ID Number:
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CSM Student ID Number:
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Do you plan to transfer additional credits from other colleges to CSM?
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Yes
No
If yes, from which college(s)?
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Full legal name:
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List any former name:
Provide the name as it should appear on diploma or certificate (legal name only; no titles; indicate punctuation):
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First Name
Middle Name
Last Name
Date of Birth:
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Mailing Address:
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address:
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Phone Number:
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The College of Southern Maryland can evaluate all courses on your transcript to determine the transferability of the courses. Do you want us to evaluate all of the courses on your transcript?
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Yes, evaluate all of the courses on my transcript
No, there are courses I do not want you to evaluate on my transcript
What courses do you want us to NOT evaluate?
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If known, what CSM course(s) do you believe your transfer course(s) are equivalent to?
Please sign to authorize your approval.
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Continue
Continue
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