Credit for Prior Learning Request

Name of Individual completing this form*

Title of Individual completing this form*

Email of Individual completing this form*

Note: Institutions are required to follow both Higher Learning Commission and State Regents policy regarding the awarding of prior learning credit.

Method of Validation*

Please select the validation method used to

American Council on Education (ACE)

Use of the system-wide assessment inventory of industry, technical, and other assessments associated with military training that have been evaluated for college credit.

The University of the State of New York's National College Credit (CCRS) Recommendations Service

Standardized examinations (e.g. AP, CLEP, or DANTES)

Degree-relevant prior learning credit awarded and transcripted by other institutions accredited as degree-granting institutions.

Assessments of individual student portfolios using Council for Adult and Experiential Learning or other standardized guidelines (CAEL)

Courses delivered on the main campus and transcipted by the Oklahoma School of Science and Mathematics (OSSM).

Higher Level courses in the International Baccalaureate (IB) Organization Diploma Program.

Institutionally prepared assessments developed by qualified faculty with content expertise.

Use of the systemwide prior learning assessment inventory of evaluated industry recognized, non-collegiate instruction programs, such as those for apprenticeships, certification, or professional licensure.

Type of standardized examination*

Select

Type of technical assessment*

Select

Select an Industry*

Please select the industry from the provided list that best aligns with the technical assessment. If you have questions please feel free to contact Angel Icenhour at aicenhour@osrhe.edu.

Select

Assessment Title(s)*

(e.g. name and any identifiers, such as: ID number or version number)

EXAMPLE:

Child Development Associate (CDA)

Course Information*

(e.g. course prefix, number, title, credit hours, and minimum score required*)

*If applicable

Note: If you are awarding block credit for prior learning list the credit how it would appear on your institution's transcript.

EXAMPLE:

CD 1103 (Teacher Community) & CD 2223 (Program Planning)

2) Assessment Modification*

Yes

No

Specific Information about modification*

(select all that apply)

Name of the assessment being used

Total credit hours being awarded

Course to which CPL is being applied

Updates to course information*

(select all that apply)

Course Prefix

Course Number

Course Title

Current Assessment & Course Information*

EXAMPLE:

American Culinary Federation – Certified Culinarian [Skills assessment also required] Culinarian® (CC®) [Skills Assessment Also Required]

CUA 1135 (Skills Development I)

Updated Assessment & Course Information*

EXAMPLE:

American Culinary Federation – Certified Culinarian [Skills assessment also required] Culinarian® (CC®) [Skills Assessment Also Required]

CUA 1136 (Skills Development I)

Credit hour update*

Credit hours awarded for the course will change from _____ to _____ .

Justification for assessment modification*

Please provide a brief summary of the reason for the requested action.

EXAMPLE:

The total number of credit hours awarded for the assessment was increased due to industry recommendations.

3) Assessment Deletion*

Yes

No

Assessment & Course Information*

EXAMPLE:

Windows Operating Systems Fundamentals (Microsoft 98-348)

CIS 2153 (Operating Systems)

Justification for assessment deletion*

Please provide a brief summary of the reason for the requested action.

EXAMPLE:

Due to advancement in technology the industry standard has moved to windows 7 and/or 8; therefore, this assessment is no longer recognized.

INSTITUTION

CONTACT INFORMATION

TYPE OF REQUEST