REQUEST FOR NON-TRADITIONAL (N) CREDIT
RLR:prc/Request for Non-Traditional (N) Credit/09-06-2019
FOR OFFICE USE ONLY
Date received: Date completed:
Completed by (Please print - Required):____________________________________________________________________________________
Signature (Required):____________________________________________________________________________________________________
N credit may be requested if a student feels that prior learning, obtained in settings other than a traditional college environment, could be
judged to be of collegiate level and equivalent to a course or courses offered at Columbus State Community College.
Students requesting a credit through Prior Learning Assessment (PLA) will:
 Meet with the appropriate department chairperson and obtain approval to develop a learning portfolio.
 Submit this completed form to the faculty advisor, along with the receipt for $50.00 obtained from the Cashier’s Office, Second Floor,
Rhodes Hall.
 Submit the completed portfolio to the faculty advisor.
NOTE: A student with only non-traditional credit on his/her academic records will be unable to obtain a transcript until the student has
successfully completed a Columbus State course. N credit is calculated as part of the earned credit hours but not as part of the grade point
average.
TO BE COMPLETED BY STUDENT (PLEASE PRINT):
Name:_________________________________________ _____________________________________ ________
LAST FIRST MI
CougarID Number: ___________________________
Program of Study:______________________________________________________________________________________
Street Address:____________________________________________________________ Apt Number:_____________
City:___________________________________________________ State:__________ ZIP Code:_____________
Daytime Telephone: (_______)_______________________ Evening Telephone: (_______)_______________________
Student Signature (Required):________________________________________________ Date: ____/____/____
PLEASE NOTE: This form will not be processed without the receipt showing the $50.00 fee has been paid. Please attach the
original receipt to this form and submit to Student Central, Upper Level, Madison Hall.
PLEASE ALLOW 10 (TEN) BUSINESS DAYS FOR PROCESSING
TO BE COMPLETED BY THE ACADEMIC DEPARTMENT:
Course Credit Credit Granted Course Credit Credit Granted
Number Hours Number Hours
________________ _______ Yes No ________________ _______ Yes No
________________ _______ Yes No ________________ _______ Yes No
________________ _______ Yes No ________________ _______ Yes No
________________ _______ Yes No ________________ _______ Yes No
________________ _______ Yes No ________________ _______ Yes No
This credit is a result of (Select one):
Work/Life Experience (Credit type LE) Industry Training (Credit type OC) Military Training (Credit type OC)
Other (Please describe): ____________________________________________________________ (Credit type OC)
Chairperson Signature: _______________________________________________ Date: ______/______/______
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