Fill - Free fillable RequestforCreditbyExperienceForm StudentNamePhonenumber Mailingaddress DegreeProgram StudentIDNumber (Johnston Community College) PDF form

JohnstonCommunityCollege–AOM Revised6/11

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 RequestforCreditbyExperienceForm

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StudentNamePhonenumber

Mailingaddress

DegreeProgram     StudentIDNumber

CourseTitle,prefixandsectionnumber

Courseprerequisite(s)

TOTHESTUDENT:CreditbyExperiencemaynotbegrantedifcredithasbeenattemptedany

otherwayandallprerequisite(s)mustbemet.Documentationmustbeprovidedthatproves

youhavemetcoursecompetenciesandhavedemonstratedknowledgeofatleast80%of

coursecontent.Scheduleameetingwithaninstructorqualifiedtoteachthiscourseandreview

acoursesyllabuswiththeinstructortoensurecompetenciesandcontentknowledgehavebeen

met.Asyllabusandallotherdocumentationmustaccompanythisrequestandmaybecome

thepropertyofJohnstonCommunityCollege.

TOTHEINSTRUCTOR:Pleaseusethecoursecompetenciesandcontentasachecklistfor

verifyingastudent’sknowledge&/orskilllevel.Commentsonthesyllabusmayserveas

documentationthatthestudenthasmetatleast80%ofthecontent.Otherdocumentation

maybe,butisnotlimitedtoportfolios,writingsamples,transcripts,certificatesorother

examplesofstudentgeneratedworkappropriatebasedonindividualcourserequirements.

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Instructor’srecommendation Approve Disapprove

Signaturesrequiredforapproval

Instructor________________________________________________ Date_____________

DirectorofProgramforCourse_______________________________ Date_____________

DeanforCourse___________________________________________ Date_____________

DeanforDegreeProgram___________________________________ Date_____________

VicePresidentofInstruction________________________________ Date_____________

Registrar_________________________________________________ Date_____________

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RequestforCreditbyExperienceForm StudentNamePhonenumber Mailingaddress DegreeProgram StudentIDNumber (Johnston Community College)

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