Outside Institutional Study Request

Request to take courses/examinations at an institution other than Missouri Baptist University to apply toward a degree at Missouri Baptist University.

This form must be completed prior to enrollment/attendance for outside institutional courses/examinations.

Student Name*

First Name

Last Name

Student Email*

Ex. 1122334@mobap.edu

Advisor Email*

Ex. John.Doe@mobap.edu

Term*

Term in which you want to take the requested course(s)

Term

Term in which you want to take the requested course(s)

Year

Ex. 2020

Name of Institution*

Institution Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Reason for Request*

Acknowledgements

My advisor and I understand the following:

The course must carry college-level credit from an accredited college or university.*

Yes No

The course must be completed with a grade of a C or better if it is a course being taken as part of my major.*

Yes No

A maximum of 70 credit hours may be accepted from a community college or other lower-level program of study to be counted toward a degree at MBU.*

Yes No

This transfer of credit may not be counted as part of the "last 24 out of 32 hour" residency requirement for degree completion at MBU.*

Yes No

An official transcript must be sent to MBU upon completion.*

Yes No

Courses

How many courses are you requesting to take?*

Course Name (1)*

Course Number (1)*

Credit Hours (1)*

Course Name (2)*

Course Number (2)*

Credit Hours (2)*

Course Name (3)*

Course Number (3)*

Credit Hours (3)*

Student Signature

Student Signature*

[clear]

Use your mouse or finger to draw your signature above

Date*

Advisor Signature

Advisor Signature*

[clear]

Use your mouse or finger to draw your signature above

Date*

Deny Outside Institutional Study Request

Yes

Course Equivalency Information

MBU Equivalency (1)*

MBU Equivalency (2)*

MBU Equivalency (3)*

Records Office

Reason for Denial*

Records Signature*

[clear]

Use your mouse or finger to draw your signature above

Date*