INSTRUCTIONS
This form should be used to request that a course be taken for credit (CY)/no credit (CN) (also commonly known as pass/fail instead
of a letter grade) for the 2020–2021 school year. This option is available only for courses that are not being taken towards specific
graduation requirements. Courses that are noted as “Certificate of Merit” may be taken if not counted towards specific graduation
requirements. A list of courses not eligible can be found here. Note:
• The grade of CY (credit) or CN (no credit) will be recorded on both the student’s report card and on the student’s transcript.
• The request to take a course as CY/CN must be made no later than the first week of the second marking period of the semester. Once
approved, this is considered final and cannot be applied retroactively at the end of the course.
• No more than two courses may be CY/CN in the same semester.
• A grade of CY or CN in a course will not be included in calculating the cumulative grade point average or for academic eligibility purposes.
• The student is required to meet all attendance and academic requirements for the course. The teacher will maintain a letter grade
equivalent in the electronic grade book.
• Use this form for approval after consulting with the school counselor about graduation requirements, college admissions, and/or other
post-secondary options.
PART 1: STUDENT INFORMATION (TO BE COMPLETED BY THE STUDENT/PARENT/GUARDIAN)
Student Name
________________________________________________________________________ MCPS Student ID:________________
School
_____________________________________________________________________________________________________ Grade ____
Home Address
________________________________________________________________________________________________________
Phone_____-_____-______
Does the student have an IEP or 504 Plan? o Yes o No
Is the student receiving ESOL services?
o Yes o No
Course(s) requested for credit/no credit: (no more than two credit/no credit courses)
COURSE NAME COURSE CODE TEACHER NAME
PART 2: SIGNATURES (TO BE COMPLETED BY THE STUDENT/PARENT/GUARDIAN)
We understand that by signing this form we agree to guidelines for credit (CY)/no credit (CN) for the courses designated on this form and
have consulted with school staff regarding impact on grade point average, graduation requirements, and other academic indicators.
Signature, Student
___________________________________________________________________________________ Date_____-_____-______
Signature, Parent/Guardian
___________________________________________________________________________ Date_____-_____-______
PART 3: REVIEW BY SCHOOL COUNSELOR
o
Reviewed
• Reviewed list of courses not eligible
• Reviewed for graduation requirements and four-year plan
o Recommend
OR
o
Do Not Recommend
PART 4: APPROVAL
o Approved
o
Not Approved If not approved, please explain _______________________________________________________________________________
__________________________________________________________________________________________________________________________
Signature of Principal or Designee
______________________________________________________________________ Date_____-_____-______
PART 5: FORWARD TO REGISTRAR. RECORD IN ELECTRONIC TEMPLATE PROVIDED TO SCHOOLS.
Copy to: Student File and Teacher
Request for Approval to
Complete a Course for Credit (CY)/No Credit (CN)
in High School Credit Courses
(FOR SCHOOL YEAR 2020–2021 ONLY)
Office of Teaching, Learning, and Schools
MONTGOMERY COUNTY PUBLIC SCHOOLS
Rockville, Maryland 20850
MCPS Form 270-32
January 2021
