AWADED TOWARD A CERTIFICATE OR ASSOCIATE DEGREE ろ S

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TRANSFER AND NONTRADIT10NAL CREDIT贅
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AWADED TOWARD A CERTIFICATE OR ASSOCIATE DEGREE
Student Nsme:
Cource of Study Currently Enrolled in:
SSN:
Credit Awarded Based On:
1. Previous Education
2. Work Experience
3, Examinations
4. Other (Identiff)
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NameNumber of Courses
L As Shown on Transcript
2. Kind of S/ork
3, Type of Examination
Date,
Prior
CACC
CACC
Validation by Attaehed Records
Term,
&/Or Yenr
Grade
Course For
Grade
&/0r
Substittttlon
Completecl
Credit
Credit Hrs
Earned
Awarded
Requlred & Signature
(Transcript Evaluator, Instructor,
Dean of Instruction, or
Associate Dean of Instruction)
4. Other (Identify)
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Total Somester Hours of Crrdit Awarded:
Copics To:
0 Studcnt Flle
0 Trarseript Evaluator
0 lmtnrotor
0 Stu&nr
Credit Posted to Student Record
Approved
ny: ;lQ ,**---t-r-,*
Dean af Instruction
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.
of Instruction
Approval Dater
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