CARTERET COMMUNITY COLLEGE
CREDIT BY EXAMINATION REQUEST FORM
Student Name
Student ID Number
Address
Course/Number/Title
Explain qualifications and attach evidence for credit by examination request:
Student Signature
I have interviewed the above named student and determined that:
He/She exhibits evidence of proficiency to the extent that his/her chances of successful completion of an exam
are good and that testing should proceed. Testing date is scheduled for
(date).
He/She does not exhibit evidence of proficiency to the extent that his/her chances of successful completion of
an exam are not good, and a test should not be given. The student has been advised of my determination.
was tested on in
(Student Name) (Date)
.
(Course Number) (Course Title)
RESULT: Passed Failed (student has been advised)
Faculty Signature
REGISTRAR’S OFFICE USE ONLY:
Credit Awarded by Date
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