Submit this form to have your course considered for transfer credit.
Please submit a separate form for each course under consideration.
Student Name: Student ID #:
Parent/Guardian Name: Academic Year:
Official Course Title: LUOA Course to Replace:
What type of course will this be?
Accredited School (Provide name in course title field)
Homeschool - Recorded as Pass/Fail
Semester (1/2 credit = 75 hrs instruction)
Full Year (1 credit = 150 hrs instruction)
Total Hours: Start Date:
Documents Required Prior to Approval:(see end of form for adding information)
Scope and Sequence (Detailed sequence of content covered)
Curriculum or Textbook Used (Include ISBN or URL)
Planned Method of Evaluation (List of tests, quizzes, labs, performances, etc.)
Documents Required Upon Course Completion:
Sample Submissions from Planned Method of Evaluation (5 for 1/2 credit, 10 for 1 credit)
Log of Instructional Hours (To include date and duration of each session)
Transcript from Institution including Final Grade
Once approved, this course may not be dropped without prior approval from an