Fillable Life Experience App (Hudson Valley Community College)

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Life Experience App (Hudson Valley Community College)

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U.S.A. forms for Hudson Valley Community College

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LIFE EXPERIENCE PROGRAM
Application
1. Date_________________________________
2. Name_______________________________________________ Student ID H00_____________
3. Address ______________________________________________________________________
4. Telephone (Work) _________________________ (Home) ________________________
5. Date of birth _______________________
6. Are you matriculated? Yes _____ No _____
7. Degree program ________________________________________________________________
8. Expected graduation date _________________
9.
College courses completed at college(s) other than Hudson Valley Community College
(attach additional sheet if necessary):
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
10. Prociency
Examstaken(checkoneormore):
CLEP _____, Advanced Placement _____, Regents College Examinations _____, DANTES ____
11. Are you enrolled at Hudson Valley Community College this semester? Yes____ No ____
If YES list course(s) _______________________ _______________________
_______________________ _______________________
12. Briey
statehowyouheardabouttheLifeExperienceProgram:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
13a. Please list those courses (include course #)
youwishtobegrantedcreditfor,basedon
your experience
.
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13b. Foreachcourseforwhichyouarerequesting
credit,listthosereasonswhyyoushould
obtaincollegecredit.Includespeciclife
experiences and number of years involved.
__________________________________
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14. IunderstandthatIwillbebilledforthecreditsrequestedatthetimeIsubmitmyportfolioand
willberesponsibleforpaymentwhetherornotcreditisgranted.
Signature __________________________________________________ Date _____________
15. A copy of your most recent resume must accompany this application. Please refer to the Life
Experience brochure for a detailed description of the program.
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Completed 26 July 2020

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