Fillable Records and Registration y Experience Request for Credit (Southern University at Shreveport)

Fill Online, Printable, Fillable, Blank Records and Registration y Experience Request for Credit (Southern University at Shreveport) Form

Use Fill to complete blank online SOUTHERN UNIVERSITY AT SHREVEPORT pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Records and Registration y Experience Request for Credit (Southern University at Shreveport)

On average this form takes 11 minutes to complete

The Records and Registration y Experience Request for Credit (Southern University at Shreveport) form is 1 page long and contains:

  • 3 signatures
  • 25 check-boxes
  • 19 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Southern University at Shreveport

BROWSE SOUTHERN UNIVERSITY AT SHREVEPORT FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
3050 Martin Luther King, Jr. Drive Phone: (318) 670-9229
Shreveport, Louisiana 71107 FAX: (318) 670-6344
www.susla.edu registraroffice@susla.edu
Policy Governing Credit by Experience
In order to recognize competence attained through educational experiences other than University instruction, the student
must adhere to the following guidelines:
• Students must have been admitted to SUSLA and must be in “good standing.”
• Credit is awarded only in areas that fall within SUSLA’s regular curricular offerings and that are appropriately
related to the student’s educational goals.
• After a student has completed at least 15 semester hours of credit at Southern University at Shreveport, the student’s
division dean will determine the extent to which the credit is applicable toward the degree.
• Cr
edit is limited to one-fourth of the number of hours required for the associate degree.
• Students enrolled in non-degree-seeking status are not eligible for credit by experience or examination.
STUDENT INFORMATION (to be completed by the student):
Semester: ⃝ Fall
⃝ Spring ⃝ Summer I or II ⃝ Summer III ⃝ LPN
Name:
Year:
SUSLA ID#:
Last First Middle
Phone: SUSLA Skymail (Email): @ skymail.susla.edu
I request credit by experience for the following:
Course
Prefix
Course
Number
Credit
Hours
Course Name
EVALUATION INFORMATION (to be completed by the instructor):
1. Technique(s) used to evaluate the CBE Portfolio or Certificate/License (check all that apply)
⃝ Interview with student ⃝ Skills demonstration/presentation ⃝ Observation of competencies
⃝ Assessment of direct documentation (including certificate/license) ⃝ Assessment of indirect documentation
⃝ Other (describe)
2. List Student Learning Outcomes (SLO) or objectives outlined in syllabus and whether student demonstrated
university-level equivalent learning.
SLO 1 Y ⃝ N ⃝ SLO 2 Y ⃝ N ⃝
SLO 3 Y ⃝ N ⃝ SLO 4 Y ⃝ N ⃝
SLO 5 Y ⃝ N ⃝ SLO 6 Y ⃝ N ⃝
3. Overall, the learning exemplified in the portfolio or certificate/license is the equivalent of a Passing Grade “P” (2.0) or
higher for the evaluated course. Y ⃝ N ⃝
Comments:
Instructor’s Signature/Date:
Division Dean's Signature/Date:
Vice Chancellor for Academic Affairs' Signature/Date:
Records and Registration
Request for Credit b
y Experience
RO: Request for Credit by Experience: 10/14:Revised 07/16:07/17:08/19-LR
Registrar’s Office Use Only
Date Processed:
Processed by:
( )
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Records and Registration y Experience Request for Credit (Southern University at Shreveport)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 26 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document