Fillable KAUAI COMMUNITY COLLEGE Request for PLA Credit by (Kauai Community College)

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KAUAI COMMUNITY COLLEGE Request for PLA Credit by (Kauai Community College)

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The KAUAI COMMUNITY COLLEGE Request for PLA Credit by (Kauai Community College) form is 1 page long and contains:

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  • 4 check-boxes
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Country of origin: US
File type: PDF

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Policy Guideline No. 4-16
Rev. April 25, 2016
Attachment 1
KAUA’I COMMUNITY COLLEGE
Request for PLA Credit by Exam
Credit by Institutional Exam (CBIE) or National Standardized Equivalency Exam (NSEE)
Students must pay the requisite fees and attach receipts to this form for request to be complete.
Name:
_
_________________
__
_________________
__
___
UH Number
_________________
Last First MI
Phone: ____________________ UH Email: _
_____________________
Major:
_
Type of PLA requested (check one):
_______________
� Credit by Institutional Exam (CBIE)
� National Standardized Equivalency Exam (NSEE)
Fill in below what course you are requesting PLA credit:
Course Alpha & Number
Name of Course
Number of Credits
Academic Advisor:
I have provided the PLA policy guidelines KCCP 4-16 to the student.
The CBIE or NSEE is recommended for the requested course.
I have discussed PLA benefits and risks with this student:
Academic Advisor Signature Print Name Date
Faculty: I have discussed this request with the student and
_
___a
gree (fee assessed)
___
disagree (no fee assessed) to authorize this PLA evaluation:
If declined, please explain here and initial:
PLA Fee * (CBIE – 50% regular tuition; NSEE – No Fee)
*PLA f ee is non-refundable even if n o credits a re awarded
_____________________________
__________________________
$_
__________
Faculty Signature Print Name Date
_____________________________
__________________________ __________
Student Signature Print Name Date
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KAUAI COMMUNITY COLLEGE Request for PLA Credit by (Kauai Community College)

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Completed 3 February 2021

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