Fillable Prerequisite Validation Form Only complete this form if (Barstow Community College)

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Prerequisite Validation Form Only complete this form if (Barstow Community College)

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Prerequisite Validation Form
Only complete this form if you require prerequisite clearance based on -
I. Prerequisite completed at another institution (attach copy of unofficial transcript)
II. Assessment Test results (attach copy of assessment test results)
III. Multiple Measures as assessed by a counselor
IV. Instructor recommendation
This form and necessary documentation should be submitted to Admissions and Records. It may be
emailed to admissions@barstow.edu or faxed to 760-252-6754.
Fall Spring Summer Year:
Section I – Student’s Personal Information
B Number
Name
Email Address
Section II – Course Information Requiring Prerequisite Clearance
Complete this section if you are attempting to clear a prerequisite for a specific course.
CRN
Subject
Course Number
Section III – Clear Prerequisite based on prior coursework
Unofficial Transcript/Assessment Test Score Attached Official Transcript send to BCC
Section IV – Clear Prerequisite based on assessment test scores
I am requesting that assessment test scores be added to my BCC record
ENGL:
MATH:
Section V – Clear Prerequisite based on Counselor Recommendation
Comments:
Counselor Signature: Date:
Section VI – Clear Prerequisite based on Instructor Recommendation
Comments:
Instructor Signature: Date:
Section VII – Office Use Only
Date form received
Approved
Denied
Assessment scores entered
by/date
Prerequisite cleared by/date
Email notification sent
by/date
Comments
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Prerequisite Validation Form Only complete this form if (Barstow Community College)

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Completed 9 February 2022

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