Fillable Minnesota State University Examination for Credit Form

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Minnesota State University Examination for Credit Form

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Examination for credit may be attempted only by MSUM students. Transient or non-admitted students are not eligible.
Examination for credit may be attempted only when the department has announced an examination or if an individual
student has received written permission of the Department Chair to take an exam. Credit may not be granted by
examination if the student has previously or is currently registered for an equivalent course. Examination credit may not
be counted as resident credit. Once the top portion of this form is complete, the student should complete the following
steps.
Last Name First Name Star or Dragon ID
Phone E-mail Address
Department Course # Course Title Credit(s)
1. Pr
esent form to Registrar’s Office in Owens Hall - proof of current MSUM student status required.
Reg
istrar’s Signature: ________________________________________________Date: ____________________
2. Pay a special examination fee of $7.50 per credit at Business Services Office. Amount Paid: $________________
Bu
siness Services Signature or Stamp:
___________________________________________________________________________________________
3. Present completed form at examination to administering faculty.
4. Aft
er examination is taken the Department Chair will send completed form to the Registrar’s Office. If
performance was a pass, the credits will be posted. If performance was a fail, no notation will be made on
transcript.
Pass or Fail? _____________
Student Signature: _____________________________________________________ Date: ________________________
D
epartment Chair Signature: _____________________________________________Date: ________________________
Minnesota State University Moorhead
Registrar’s Office | Owens Hall 210
1104 7
th
Ave S
Moorhead MN 56563
Phone: 218.477.2565 Fax: 218.477.2941
Email: Registrar@mnstate.edu
Minnesota State University is an equal opportunity educator & employer and is a member of the Minnesota State System.
Examination for Credit
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Minnesota State University Examination for Credit Form

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Completed 14 April 2020

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