Fillable Requestfor Evaluationand Transferof Previous Credits (Chemeketa Community College)

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Requestfor Evaluationand Transferof Previous Credits (Chemeketa Community College)

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Office of Transcript Evaluation Services, 4000 Lancaster Drive NE, Building 2, Room 200,Salem, OR
Mailing Address: PO Box 14007, Salem, OR 97309-7070
Phone: 503.399.6588 Fax:503.399.3918 Email: evaluation@chemeketa.edu
Chemeketa Community College is an equal opportunity/affirmative action employer and educational institution. To request this publication in an
alternative format, please call 503.399.5192.
11/19/2015 s:\registrar\forms\request for evaluation and transfer of previous credits.docx chemeketa.edu
Request for Evaluation and Transfer of Previous Credits
Use this form to request an evaluation of previous credits from prior institution(s). Courses are evaluated based on best fit for program listed. Once the
evaluation is complete an email will be sent to your MyChemeketa account.
1. Complete and submit this form to one of the following: Enrollment Center, Transcript Evaluation Window 13 in Bldg. 2, fax, or to
evaluation@chemeketa.edu
a. Transcripts must be official and from a regionally accredited institution to be evaluated. We do not accept faxed transcripts.
b. Evaluations are processed once all transcripts listed on the form have been received.
c. Turnaround time is 2-3 weeks depending on the volume of requests.
Student ID (K#): Date of Birth (mm/dd/yyyy):__________________
Name (as it appears in our records): __________________________________________________________________
Mailing Address:__________________________________________________________________________________
Street City State Zip
Phone Number with Area Code: Cell Phone: _______________________ Home Phone: ________________________
Previous Name(s) Used: __________________________________________________________________
Check Only if Applicable:
I am attending Chemeketa under Veteran Affairs (VA) Benefits
(Submit this form when enrolling for your first term at Chemeketa. All prior credit needs to be evaluated and reported by the end of your third
term at Chemeketa)
I have applied for a degree or certificate at Chemeketa
(Submit this form and your Application for Graduation by the end of the fourth week of the term prior to the expected term of
graduation)
I am applying for a limited enrollment program at Chemeketa
(All Chemeketa programs are listed on the second page of this form. Limited enrollment programs are designated with an *)
Chemeketa is not required to accept all credits from other institutions. Submitted transcripts will not be returned or
photocopied.
Schools Providing Transcripts for Evaluation:
School: School:
School: School:
I have requested official transcripts be sent to Chemeketa
Please use transcripts that are currently on file from a previous evaluation for a different program
PLEASE PRINT THE PROGRAM NAME:
Student Signature: _________________________________________________________Date:___________________
click to sign
signature
click to edit
Office of Transcript Evaluation Services, 4000 Lancaster Drive NE, Building 2, Room 200,Salem, OR
Mailing Address: PO Box 14007, Salem, OR 97309-7070
Phone: 503.399.6588 Fax:503.399.3918 Email: evaluation@chemeketa.edu
Chemeketa Community College is an equal opportunity/affirmative action employer and educational institution. To request this publication in an
alternative format, please call 503.399.5192.
11/19/2015 s:\registrar\forms\request for evaluation and transfer of previous credits.docx chemeketa.edu
Certificate of Completion (1 year)
Accounting
Accounting
Accounting-Tax Preparation
Accounting – Payroll
Accounting – Baccalaureate Preparation
Apprenticeship
Construction Trades, General Apprenticeship – HVAC/R
Specialization
Construction Trades, General Apprenticeship – Plumbing
Specialization
Construction Trades, General Apprenticeship – Sheet Metal
Specialization
Electrician Apprenticeship Technologies
Automotive Technology
Automotive Body Repair
Automotive Entry Level Technician
Automotive Machining
Business Technology
Administrative Office Professional - Business Software
Administrative Office Professional - Business Technology
Administrative Office Professional - Office Fundamentals
Administrative Office Professional - Virtual Office Assistant
Computer Information Systems
Computer Programming
Computer Support Specialist
Computer Systems Administration
Database Developer
Network Management and Systems Security
Web Developer
Criminal Justice
Juvenile Corrections
Law Enforcement - Basic Corrections
Law Enforcement - Basic Law Enforcement
Dental Assisting
Drafting Technology
Computer-Assisted Drafting (CAD)
Computer-Assisted Drafting (CAD) - Architectural Drafting
Early Childhood Education
Early Childhood Education
Infant/Toddler
Preschool
Electronics Technologies
Electronic Engineering Technician - Electronics
Electronic Engineering Technician - Process Control
Fire Protection Technology
Fire Service Supervision and Management
Health Information Management
Basic Health Care
Hemodialysis Technician*
Hospitality Management
Event Management
Hospitality Management
Human Services
Addiction Studies - Addiction Counselor Certification Preparation*
Human and Social Services Traditional Health Worker
Machining Technology
Basic Manufacturing Technician
CAD/CAM - Computer-Aided Manufacturing (CAM) Fundamentals
CAD/CAM - Computer Numerically Controlled (CNC) Operator
CAD/CAM - Manual Machine Operator
Management
Procurement Management
Retail Management
Sustainability in Management
Medical Assisting*
Nursing
Practical Nursing*
Occupational Skills Training
Pharmacy
Pharmacy Management - Pharmacy Technician*
Speech-Language Pathology Assistant*
Tourism and Travel Management
Destination Marketing
Tourism and Travel Management
Vineyard Management
Vineyard Operations
Welding Fabrication
Welding*
Associate of Applied Science/Transfer
(2 year)
Accounting
Apprenticeship
Construction Trades, General Apprenticeship – HVAC/R
Specialization
Construction Trades, General Apprenticeship – Plumbing Specialization
Construction Trades, General Apprenticeship – Sheet Metal
Specialization
Electrician Apprenticeship Technologies
Associate of Arts – Oregon Transfer
Associate of Science/Oregon Transfer in Business
Associate of Science/Oregon Transfer in Computer Science
Associate of Science
Associate of General Studies
Automotive Technology*
Business Technology
Administrative Office Professional
Administrative Office Professional - Accounting Administrative
Assistant
Administrative Office Professional - Medical Administrative
Assistant
Administrative Office Professional - Virtual Office Assistant
Computer Information Systems
Computer Systems and Information Technology
Criminal Justice
Criminal Justice
Juvenile Justice
Law Enforcement*
Law Enforcement – Corrections*
Drafting Technology
Computer-Assisted Drafting (CAD)
Early Childhood Education
Electronics Technologies
Electronic Engineering Technician
Electronic Engineering Technician - Computer Electronics
Electronic Engineering Technician - Industrial Electronics
Electronic Engineering Technician – Process Control Technology
Electronic Engineering Technician – Renewable Energy Management
Fire Protection Technology
Fire Prevention
Fire Suppression*
Health Information Management*
Horticulture
Horticulture
Hospitality Management
Human Services
Addiction Studies*
Social Services*
Machining Technology
Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM)
Management
Management
Procurement and Supply Chain Management
Nursing*
Paramedicine*
Pharmacy
Pharmacy Management*
Speech-Language Pathology Assistant*
Tourism and Travel Management
Vineyard Management
Visual Communications
Graphic Design*
Graphic Design – Interactive Media*
Welding Fabrication*
Wine Business
Winemaking
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Requestfor Evaluationand Transferof Previous Credits (Chemeketa Community College)

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Completed 25 July 2020

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