Fillable Chadron State College Credit Evaluation Request

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Chadron State College Credit Evaluation Request

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CHADRON STATE COLLEGE T
CREDIT EVALUATION REQUEST
Bachelor of Science in Education
Date____________________ Student Identification Number___________________________
Name_______________________________________________________________________
Last First Middle Maiden
Address__________________________________________ City________________________
State/Zip____________________________ Telephone #_____________________________
CSC Advisor_________________________ Anticipated CSC Graduation Date____________
Date you entered or plan to enter CSC_____________________________________________
Semester & Year
Catalog 03-05 05-07 07-09 09-11 (Please Circle one)
You may use only ONE General Bulletin for your entire program.
Colleges transferred from: (Please include number of hours completed.)
___________________________________ ___________________________________
___________________________________ ___________________________________
**Will you have an Associate of Arts Degree before transferring to CSC?
_____Yes _____No If yes, from what college/university?________________________
COMPLETE ONE OF THE FOLLOWING SECTIONS USING EXACT PROGRAM TITLES AND
PAGE NUMBERS STATED IN YOUR CATALOG.
1) Elementary Education (One Minor or an Endorsement Required)
Endorsement___________________Page #____ Minor___________________Page #____
Endorsement___________________Page #____ Minor___________________Page #____
2) Secondary Education (One Endorsement Required)
Field_________________________Page #____ Subject__________________Page #____
Field_________________________Page #____ Subject__________________Page #____
3) Are you seeking a supplemental endorsement in Coaching? Yes______ No_______
7/09
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Chadron State College Credit Evaluation Request

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Completed 10 April 2020

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