University of Illinois Springfield
Internships and Prior Learning Services IPL
One University Plaza MS BRK 482 • Springfield, IL 62703-5407 5.16
217-206-6640 • Fax: 217-206-7415 •
Prior Learning Course Application IPL 305/501
1. The student should complete this form AFTER speaking to his/her academic
2. Once completed, the student should obtain departmental approval on page 2.
3. Submit the completed form to IPL in Brookens 482 or; upon
approval, the student will receive an email regarding course approval to
register for the prior learning course, IPL 305 or IPL 501 (graduate credit).
Course Registration for (Semester/Year): Spring 20____ Summer 20____ Fall 20____
Student Name: _______________________________ University ID Number: _______________________________
Phone: _______________________________ UIS Email Address: _______________________________
Academic Program/Major: _________________________ Academic Advisor: _______________________________
Hours completed at UIS: _____________ Total hours completed: _____________
Are you a graduate student? Yes No Expected Graduation Date: ___________________________
How did you hear about the prior learning course/program? ___________________________________________________________
Undergraduate students should enroll in 3 credits of IPL 305. If you are seeking more than 3 credits, consult with an IPL
Coordinator to determine the number of credits you may earn.
Graduate students should enroll in 4 credits of IPL 501.
How will you use this credit? (Consult with your advisor if needed.)
ECCE Engagement or ECCE Elective? Number of Credits ______
General Electives? Number of Credits ______
Other? __________________________________ Number of Credits ______
Is this your first prior learning portfolio*? Yes No
*If this is not your first portfolio, speak to an IPL Coordinator regarding the process for earning additional portfolio credit.
For IPL Office Use
IPL 305/501
If you have questions, please email Rachel Price at or call 217-206-6695.
1. Describe, in detail, the proposed prior learning experience you wish to receive credit for (e.g., professional training; certification;
volunteer work; military service; individual research; independent study; travel).
2. Briefly explain how you believe what you learned in this experience can be applied to situations outside of the setting in which you
learned it.
The student must seek approval from a faculty member, academic advisor, or department chair in his/her department.
I agree that this student should complete the prior learning course for his/her degree progress.
Printed Name: _____________________________ Signature:____________________________________ Date:____________
I verify that I have not received credit nor attempted to receive credit from the University of Illinois Springfield or any other
higher education institution on the basis of the work I will prepare for this portfolio.
Student Signature: ________________________________________________ Date:________________
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