Credit for Prior Learning Portfolio Form
Student Name _________________________________________________________________________________________________
Student ID# ____________________ Program ___________________________________________________________________
MTI Equivalent Course
Course Number ___________________________ Course Title _____________________________________________________
______________________________________________________________ ________________________________________________
Student Signature Date
Requests for credit for prior learning experience for a student with verifiable work experience must be accompanied by a portfolio to
demonstrate that the student’s knowledge is equivalent to what would have been learned in a comparable MTI course. The portfolio
must include the following sections:
1. Course syllabus (available from the instructor or the registrar), including course description and learning objectives
2. Credit for Prior Learning Portfolio Form completed and signed by student and business office staff
3. Academic Honesty Statement signed by student
4. Current resumé
5. Course specific prior learning narrative detailing your personal experience and learning that equates to the course learning
objectives
6. Documentation to demonstrate learning of course objectives (work samples, awards, employer letters, etc.)
A non-refundable evaluation fee of $50 (up to three credits, $10 for each additional credit) per portfolio is required at the time the
student submits a portfolio for evaluation.
______________________________________________________________ ________________________________________________
Business Office Staff Signature verifying payment Date
For office use only
Approved Denied
Reason(s) ______________________________________________________________________________________________________
__________________________________________________________________________________________________________________
________________________________
__________________________________________________________________________________
______________________________________________________________ ________________________________________________
Faculty Signature Date
______________________________________________________________ ________________________________________________
Dean of Academics Date
Mitchell Technical Institute
1800 East Spruce Street Mitchell, SD 57301 ∙ www.mitchelltech.edu
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