Campus Transfer Request


Campus Transfer Request

In accordance with the School Policy, all online programs are to provide this form to any student who is joining online from all TMIKY campuses whether or not the student is “in good standing” and whether or not their student records are up-to-date and complete. “In good standing” means that the student’s records include financial, personal, and program documents, and is entitled to attend classes, as of the date of this form. This form is to be submitted with student file and sent directly to the student’s new campus they will be attending.

Name of Student: Gender:

Program:  

Street Address:  

City: State:   Zip Code:  

Name of Emergency Contact:   Emergenct Contact Phone:  

Location Transferring to:

Name of Administrator at New Campus:  

Location Transferring from:

Name of Administrator at Previous Campus:  

Please check (√) the appropriate box.

If student is not in "good standing", please explain below.

 

Leave this empty:

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The Medical Institute of Kentucky https://tmiky.com
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Document name: Campus Transfer Request
lock iconUnique Document ID: e3ad628ff39d58a2451bcc82da441f365ac38663
Timestamp Audit
May 5, 2020 2:04 pm GMTCampus Transfer Request Uploaded by Cassie Black - [email protected] IP 99.190.9.234
May 6, 2020 12:57 pm GMTTMIKY Student Forms - [email protected] added by Cassie Black - [email protected] as a CC'd Recipient Ip: 71.143.223.187