Parkland College
PETITION FOR CREDIT BY EXAMINATION (PROFICIENCY EXAMINATION)
Instructions on page 2
STUDENT INFORMATION (please print clearly or type)
Last name __________________________________________ First name _____________________________
Student ID ___ ___ ___ ___ ___ ___ ___ ___ Daytime phone (________)_________________________
Street Address _____________________________________________________________________________
City, State, Zip ________________________________________ Parkland Email ________________________
REQUEST
I request permission to take an examination to demonstrate my mastery of the knowledge and skills for the course indicated
below. If successful, the course will become part of my permanent record with a “P” (proficiency) grade. I understand that
another institution may not accept the credit for transfer. (It is my responsibility to determine acceptability of credit.)
Course Prefix & Number: ___________ Course Title: ________________________________ Credit Hrs: ____
Related educational or work experience Place Dates
_________________________________________________ ___________________ _______________
_________________________________________________ ___________________ _______________
Explanation:
___________________________________________________________________________________________
___________________________________________________________________________________________
Student’s signature ___________________________________________________ Date __________________
FOR ADMINISTRATIVE USE ONLY
Eligible for Examination Department Chair ____________________________ Date _________
Completion of Alternative Examination (Licensure or certification exams)
Current Employment Status replaces Work Experience Course
If approval is granted, the applicant should present this form at the Cashier Office (U250) and pay the necessary fee. After the
fee payment, the applicant will make arrangements with the department chair or designee to take the examination.
Paid fee of $ _____________ Cashier __________________________________ Date _________________
Applicant returns form with payment verification to department chair and makes arrangements for the examination.
Date examination administered _________________________
Passed
Failed
Examiner ____________________________________________________________ Date _________________
Credit granted ________ hours
Credit denied
Approved by _________________________________________________________________________
Dean Division Date
Revised July, 2016 1
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Credit Earned by Examination (Proficiency)
To attempt to earn credit by examination (proficiency), a student must fulfill the following conditions:
1. Be enrolled currently at Parkland College
2. Has not attempted to earn credit previously by examination in the same course
3. Has not completed the course previously with an A, B, C, D, F, N, T, or W grade.
All exceptions to these conditions must be discussed with and approved by the dean of the division.
P
ROCEDURES FOR STUDENT
1. Type or print all information requested on the form and sign it.
2. Take the petition to the appropriate department chair for approval
Academic departments: Agriculture/Engineering Science and Technologies, Business/Computer Science and
Technologies, Fine and Applied Arts, Health Professions, Humanities, Mathematics, Natural Sciences, and Social
Sciences and Human Services.
3. Pay the required fee to the college at the Cashier Office (U250). The cashier signs the petition form to
confirm payment.
4. Return the form to the appropriate department chair (or designee) and make arrangements to take
the proficiency examination.
P
ROCEDURE FOR THE EXAMINER
After administering and evaluating the exam, the examiner will indicate the results on the petition, sign it, and
forward the form to the Division Dean.
R
ECORDING OF CREDIT
Based on the results of the examination, the Division Dean approves or denies the petition. The petition form
is be sent to the office of Admissions and Records for recording.
Approval: For credit to be recorded on the student’s academic transcript in the current semester, an
approved petition must be received by the office of Admissions & Records no later than the last day of
instruction for the current semester; otherwise, the credit will be recorded in the next semester for which
the student is officially enrolled.
Denial: If the student fails the proficiency examination, Admissions & Records makes a notation in the
student information system (STRK screen) that the proficiency exam has been attempted and may not be
repeated. Failure of a proficiency exam will not be indicated on the student’s academic transcript.
I
NFORMING THE STUDENT
Admissions & Records returns a copy of the form to the appropriate academic department. The department
informs the student of the results by email, attaching a scanned copy of the form.
Revised July, 2016 2