Petition for Articulated Credit
• Form should be initiated by the student requesting articulated credit.
• Form should by typed or printed neatly in ink.
• Student must complete, initial and sign form.
• Requests for Articulated Industry Certification or Advanced Standing Credit should be sent to the Office of the
Registrar along with specified documentation.
• Requests for Credit for 3rd Party Training, Articulated PSAV/ATD Program, Credit for Current Licensure, o
r
C
ompetency Based Credit should be sent for preliminary review to the Program Manager/Coordinator.
• Student will receive email notification of final decision from the Office of the Registrar.
STUDENT TO COMPLETE PAGE 1 AND THE TOP PORTION OF PAGE 2
Last Name:______________________________________ First: ________________________________ Middle:______________________________
Date: ____________________Student ID: B______________________ Daytime Phone number with area code: _______________________________
Mailing Address:_____________________________________________________________________________________________________________
City:___________________________________________________ State: ____________________________________ Zip:______________________
Degree You are Seeking at EFSC: ___________________________ Major:______________________________________________________________
Note: Your Degree and Major must align with specified requirements for the articulated credit you are requisition
I am requesting college credit based on one of the following articulation methods:
Articulated Industry Certification (INDCER)
Name of Certification:_________________________________________
Date Awarded:_______________________________________________
Note: Credit awarded per current MOU. Attach copy of certificate.
Advanced Standing (ADVSTA)
Brevard Public Schools / High School Courses Completed
Course_____________________________________________________
Grade and Date Received: ____________________________________
Note: Graduated HS no more than 3 years prior to date of this petition.
Attach copy of high school transcript.
Credit for 3
rd
Party Training (INDART)
Name of Training: ___________________________________________
Date of Training: _____________________________________________
Note: Attach copy of training record.
Articulated CTC/ATD Program (FLPSAV)
CTC/ATD Program: ___________________________________________
Graduation Date: ____________________________________________
School Attended: ____________________________________________
Note: Attach copy of transcript.
Credit for Current Licensure (INDLIC)
Licensed Title: ______________________________________________
Date Completed: ___________________________________________
Note: Attach valid copy of current license.
Competency Based Credit (EXPLRN)
Course(s) Completed: _______________________________________
__________________________________________________________
Date Completed: ___________________________________________
Note: Attach copy of documentation required by MOU.
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SCA-145 R011019