Edinboro University of Pennsylvania Life Experience Credit Application Please note: To ensure that life experience credits are posted to your transcript prior to the end of the semester, the application and portfolio should be received two months prior to the last day of the semester. Application and portfolio can be mailed or delivered to: The Office of Adult Student Services 405 Scotland Road, 211 Pogue Student Center, Edinboro, PA 16444 1. First Name 2. M.I. 3. Last Name 4. Telephone Number ( ) 6. E-mail Address 5. Student ID @ 7. Street Address 8. City 9. State 11. Major 12. Advisor 10. Zip 13. Please state how you learned about life experience credits: 14. Please list the courses in which you are seeking life experience credits: Course Number(s) Course Title(s) 15. Life Experience Fees: Application fee.......................................................$25.00 Evaluation fee: One department...................................................$100.00 Each additional department.................................$50.00 Transcript posting fee.............................................$25.00 PER CREDIT Application and evaluation fees are posted to your student account when your portfolio is submitted to the Office of Adult Student Services. The transcript posting fee will not be posted to your student account unless/until life experience credits are awarded. 16. I understand that the life experience application and evaluation fees are non-refundable and will be posted to my student account when I submit the application and portfolio to the Office of Adult Student Services. I also understand that if credit is awarded, the transcript posting fee will be posted to my student account. Student Signature Date