BREYER STATE UNIVERSITY

"Innovation in Curriculum Design"

PRINTABLE FORM

REQUEST FOR PRIOR LEARNING CREDIT FOR COURSE EQUIVALENT

ONLINE DEGREE PROGRAMS


Last Name:__________________________________ First:_________________________________
Address: __________________________________ City:________________________ State:______
Country:__________________ Zip:_____________________ Phone:(            )__________________
Email Address:_____________________________________________________________________
Check One: _____ Currently Enrolled Student _____ Not Enrolled
For Currently Enrolled Students:
_____ Certificate _____ Associate Degree _____ Bachelors Degree _____ Masters Degree
_____ PhD _____ Doctorate _____ Other              BSU Student # :______

Date you are completing this request:____________________________________________________
Please provide complete information below regarding the course you are requesting prior learning credits for:
Degree Program offered by Breyer State:________________________________________________
Course Title:__________________________________________ Course # :____________________
Course Semester Hours: __________________ Course Instructor:_____________________________
 

I. Provide a copy of your current job position vita resume. You must be able to demonstrate that your job description supports prior and ongoing learning related to the course you are petitioning credits for.

II. If your current job/position does not support skills/learning based on the content of the course, then please provide an explanation of your past experiences which you believe qualify you for the equivalent learning/skills.

III. If you have completed any non-college courses/educational programs/seminars, that you believe are related to the course content, then you must provide copies of Certificates of Completion, or copies of official letters or other related documents supporting this completion.

IV. If you have published in the subject area of the course content, then please submit a copy of the article or the front pages of a book, demonstrating verification.

V. You are to include a list of the learning objectives for this course, as defined in the current syllabus, located on the website.

VI. Provide an abstract detailing your learning/skills/knowledge directly related to the course you are petitioning for credits. Please include the number of months/years that you have work/career experiences related to the course you are petitioning for credits. You must develop your abstract so that your documentation focuses on how you have achieved the defined course objectives through prior learning. A good abstract should be at least 3-4 pages, double-spaced. The abstract is a key component for assessment by the Academic Officer, and you should insure that it is very complete and adequately defines your prior learning and related skills/knowledge acquisition in terms of the course objectives and content for which you are seeking credit award.

VII. You must provide a summary narrative defining why you believe you have met the course objectives based on prior learning in the subject area. You should also include in the summary, a list of key knowledge areas and skills sets you have achieved related to the course content. Include any outstanding accomplishments related to the course content.

VIII. Submit only one completed application per course that you are requesting evaluation for experiential credits. If you are requesting experiential credits for more than one course in a degree program, you must submit a completed application for each one, and pay the $200.00 fee, per course request.


DIRECTIONS:

1.      This form must be completed in its entirety in order to be processed.
2. The cost for evaluation for prior learning credits is $200.00 per course. Again, an application must be filled out with each course that you wish to challenge. Payment must be made at the time of the submission. If a student is denied credits for the course due to a lack of verifiable experiences/knowledge, and/or skills, then the student will be refunded $150.00. There is a $50.00 non-refundable administrative fee for the review.
3. Payment may be made via personal checks or bank checks made payable to: Breyer State University-Alabama, mailed to 2100 Southbridge Parkway, Ste # 650, Birmingham, Alabama, 35209.
4. We also accept all major credit cards. You may use our online secure credit card server by accessing our web site at http://www.breyerstate.com/pay.htm If you are paying by credit card via our secure server, then you may e-mail your application to adm@breyerstate.com, or fax it to: 205-414-7499.
5. The required content for I through VII above, must be typed/word processed. Handwritten submissions will not be reviewed.
6. Do not submit "portions" of your completed application for prior learning credits. You must submit the entire application at one time. If you are applying for prior learning credits for a course in a Masters level degree program, you must submit a copy of official transcripts verifying your award of a Bachelors Degree. If you are applying for credits for a course in a PhD/Doctorate degree program, you must provide a copy of official transcripts verifying award of a Masters Degree. If you are not able to submit copies of transcripts with the application, then all committee approvals shall be contingent upon Breyer State University receiving such transcripts. If you have previously submitted copies of transcripts, prior to submission of this application, then you need not resubmit them.
7. Once your completed application and payment are received, you will receive a written decision via e-mail within 2-3 weeks of receipt of your completed application. If your application is accepted and you are a currently enrolled student at Breyer State University, then you will receive notice that you have been awarded semester hours of credits for the course you petitioned for. The course and credit hours awarded will be placed in your student file, and will appear on your official transcripts. Please note that semester credit hours are awarded for prior learning assessment courses and there are no letter grades assigned. Your transcript will reflect that you have "passed" the course and have received the total number of semester hours for the course.


 Policy:  Academic Officers in the subject area/discipline of the course you are applying for credits will complete the review and evaluation of submitted applications. Academic Officers follow a comprehensive set of evaluation criteria as they assess each submitted portfolio. Academic Advisors make the final decision on whether or not the applicant has demonstrated sufficient prior learning/knowledge and skills attainment related to course objectives and content, to allow for the approval of credits for the course. Academic Advisors may also decide that there is partial fulfillment of prior learning, but not enough to warrant the award of course credits; and thus, recommend that applicant be able to “challenge the course” via an online examination. If an Academic Officer denies the application based on standards, then, the applicant would have to register for and take the course to receive credits.

You may contact the Dean of Students studean@breyerstate.com for questions or needed assistance.

PLEASE COMPLETE THE FOLLOWING VERIFICATION STATEMENT:

I, _________________________________________________ hereby do agree that my application and all accompanying submissions are true as presented. I further agree that Breyer State University retains all rights to contact employers, education agencies/associations, to verify any of this submitted content. I fully understand that if I have falsified any information or provided intentional misleading information, then Breyer State University retains the right at any time to rescind any credits that have been awarded as a result of this application. My signature below verifies the truth of the content of my application and my voluntary willingness to accept the terms of this evaluation.


_______________________________________ ________________________
Signature/ Date


* Note: if you are submitting your completed application by email file, you must type your full name in the signature area above, as well as the date. The presence of your typed name and the date of submission are provided by you as acceptance to the terms and conditions of this application.