SCA College of Svatý Sebesta
Request to Transfer Class Credit

Complete and Mail to:
Chancellor of Svatý Sebesta
PO Box 1 Vermillion SD  57069

Please Fill out the following information by printing legibly:

Required Information:
Information contained in this section is used by the Collegium to maintain Registrar and Attendance records. It may be made available to other SCA entities through published Reports or on the Collegium's web site.

SCA Name:  __________________________________________________________
Local SCA Group: __________________________________________________
SCA Kingdom: __________________________________________________
Are you already registered with the Collegium?  Yes ___  No ___

If yes, under what name(s) are you registered? ___________________________________________
Title and/or Designation of Class Taken: _______________________________________________
Date and Location of Class: _________________________________________________________
Name of Instructor:  _______________________________________________________________
How we may contact instructor:  ______________________________________________________

Do you wish to transfer this class as an elective or substitute it for a required class?  __Elect __ Req
Title and/or Designation of Required class you wish to substitute: 
_______________________________________________________________________________
Please use the back of this form for any additional contact or class information.
Optional Contact Information:  May only be used internally within the Collegium.
Mundane Name: __________________________________________________
Mundane Address: __________________________________________________
__________________________________________________
__________________________________________________
Phone: (    )  __________      E-mail Address: _______________________________

To Be Completed by Collegium Staff
Date Received: ____________       Received by: ______________________________
Date Approved by Registrar:  _______________  Signature:______________________________
Date Approved by Provost:   _______________  Signature:______________________________
Date Entered:  __________ by  _____________________________________________
Confirmation Mailed to:   ___  Student      __  Chancellor      ___  Provost    __  Local Group

Form Revision Date: March 24, 2002