Admissions & Records April 2018 Page | 1
AMERICAN RIVER COLLEGE COMPLETE A SEPARATE FORM FOR EACH PREREQUISITE
PREREQUISITE
EQUIVALENCY FORM
Student ID Number
Received By / Date
N
AME
DAY PHONE DATE
This form allows students to utilize external English or Math course completion, Early Assessment Program participation, Advanced
Placement (AP), International Baccalaureate (IB), or College Level Examination Program (CLEP) scores to satisfy prerequisites and allow
enrollment in English Writing (ENGWR), Math and Statistics (STAT) courses. Students currently in progress, or who have completed the
prerequisite course within the Los Rios Community College District, will have the ability to enroll in the next level course for the
following semester without submitting this form. If the determination cannot be made at the time of submission, you will be notified
via email at your Los Rios Gmail account at apps.losrios.edu.
I have completed an English or Math assessment in the Los Rios Community College District:
Yes
No
Semester or Term Applicable:
Summer
Fall
Spring Year:__________
I want to enroll in the following ARC course:
T
he prerequisite for this course is:
I am using a course completed at another college/university to satisfy the prerequisite
Pr
ovide academic transcript to verify the information provided. Attach a course description of the completed class.
I am using EAP/CAASPP to satisfy the prerequisite
Provide copies of your EAP/CAASPP scores; if your results indicated Conditional Readiness (a score of 3), provide a copy of your high
s
chool transcript and course description for your most recent high school English/Math course (whichever is applicable).
I am using AP, IB, or CLEP scores to satisfy the prerequisite
Provide copy of your applicable scores; official scores must be submitted to Admissions to award credit from your AP, IB, or CLEP results.
Please complete applicable fields below. For EAP and AP participants, please indicate the score received and information on the highest
English Writing/Math course you completed in high school applicable to the course you have listed above.
I declare under penalty of perjury that the statement and information submitted on this form are true and correct. I understand that all
material and information submitted by me for the purpose of verifying the completion of a prerequisite, which the college has deemed to
be valid and necessary for success in a course, become the property of American River College and are subject to audit. I also understand
that falsification and withholding pertinent data will result in immediate withdrawal from a course and further disciplinary actions.
Student Signature: Date:
ADMISSIONS OFFICE
DEPARTMENT OFFICE
MATRICULATION
Transcript
Official
Unofficial
UNOFFICIAL TRANSCRIPTS WILL NOT BE RETAINED
Milestone Set: _____________
Processor’s initials/date
T
ransfer Credit: _____________
Processor’s initials/date
Request for equivalency:
A
PPROVED
D
ENIED
Reviewer’s Signature/Date: _______________
M
ilestone Set: _____________
Processor’s initials/date
Student Notified: _____________
Processor’s initials/date
External Assessment
EAP Participation
No Entry Necessary
E
ntered: ____________
Processor’s initials/date
College/University/School Name or Advanced Placement Test
Course Name/Number or AP Test (Ex: STAT 300 or AP Calculus BC)
Units
Letter Grade
Test Score
Course Name/Number (Ex: STAT 300)
Course Name/Number (Ex: MATH 42)