Fillable Request for Academic Prior Learning Assessment (Course Challenge) (Green River Community College)

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Request for Academic Prior Learning Assessment (Course Challenge) (Green River Community College)

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11/29/17
Request for Academic Prior Learning Assessment (Course Challenge)
Student Name: SID:
Telephone: Email:
I understand that Prior Learning credits are limited to 25% of my degree requirements and that transferability of
the credits may be limited.
Student Signature: Date:
Course(s) for which credit is requested:
What Degree/Certificate is this course for?
# of PLA credits requested: (Note: partial credit only permitted on variable credit courses.)
PLA 099 Independent Study Course
# of credits for evaluation (1-2): YRQ: CRS: PLA 099 Sec: Item:
This section to be completed by Faculty Member:
(Please attach class syllabus and any other documents used for evaluation):
What method of assessment was used?
What outcomes/competencies were measured?
Quarter: Grade Assigned: Pass/No-Credit: Decimal Grade:
Faculty name: Faculty Signature:
Division Chair signature:
Dean signature: Date:
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Request for Academic Prior Learning Assessment (Course Challenge) (Green River Community College)

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Completed 9 October 2020

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