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.
Page 1 of 2
SCA-145 R011019
STUDENT TO COMPLETE
Student Initials ____________ I understand that credit awarded may have an impact on total financial aid awarded.
Student Initials ____________I understand that credits received are intended for the EFSC degree prescribed in the articulation agreement.
Student Initials ____________ I understand that grade of “S” will be posted. This institutional credit may not transfer to another college or university
as this is dependent on the policies of the institution.
Student Initials ____________I understand that in order for a certificate or degree to be awarded by EFSC, a minimum of 25% of the degree/program
requirements must be completed through instruction at EFSC. Articulated credit is not considered instructional coursework taken at EFSC.
Student Signature: ________________________________________________________________________ Date:_______________________
EFSC STAFF, FACULTY, OR ADMINISTRATION TO COMPLETE THIS SECTION.
Name:________________________________________________ Title: _____________________________________
(Please print legibly)
I have verified that the student has met all requirements as prescribed on the MOU and has provided documentation in accordance
with the articulation method for which they are requesting credit.
Signature: __________________________________________________________ Date: ____________________
Please award the following credits for the __________________________________________________________Degree.
OFFICE OF THE REGISTRAR TO COMPLETE
Approved_____ Not Approved_____
Comments after review: _______________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Print Evaluator Name: ___________________________________________Title: _________________________________________
Evaluator Signature: _____________________________________________________________Date:_________________________
Page 2 of 2
COURSE
NUMBER
COURSE TITLE
CREDIT
HOURS
Total Credits Awarded
click to sign
signature
click to edit
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