Verification of Intent to earn Associate of Arts/Science Degree-Transfer

NOTE: Upload one form per ADT.

Full Name: Full Name: First Middle Last
Student ID# G00:
IVC Email:
Date of Birth: Date of Birth: / MM / DD YYYY
Preferred Method of Delivery:
Mailing Address: Mailing Address:
Street Address City State / Province / Region Postal / Zip Code
Please provide your mailing address below if you selected "Mailing Address" as your preferred method of delivery.
Upload the signed Verification of Intent to earn Associate of Arts/Science Degree-Transfer Form along with an IVC student ID or valide government issued picture ID for verification:

Attach Files
By submitting this form, the official at the community college at which the student intends to earn the AA-T/AS-T degree is verifying that the student has completed more than half of the graduation requirements for the degree and could complete the degree within the remaining standard academic terms prior to transfer.
Student Signature:

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Full Name

I understand this is a legal representation of my signature. Use mouse to sign.