SCHOOL FOR NEW LEARNING
TRANSFER COURSEWORK ASSESSMENT FORM
STUDENT
ID:
EMAIL
CURRENT QUARTER & YEAR
_______________
Competence Letter and Number: _____ ______ _______
Letter
Number Letter
Or ______FX All Focus Area transfer courses should be identified as FX.
COMPETENCE STATEMENT:
_________
COLLEGE: _____________________
Department: ________________________
COURSE TITLE: ____________________________________________________________
COURSE NUMBER:
GRADE RECEIVED
YEAR
CREDIT HOURS
Your mentor will submit the request for transfer of the course to the competence you specify.
Upon review of the request, you will receive notification if the transfer is approved. If it is
not approved, you will receive this form with specifications by the reviewer about the basis
for that decision.
SUBMIT THIS FORM TO YOUR MENTOR AS A WORD DOCUMENT.
Upon approval, your mentor will send by e-mail to begin the review process.
The submission by the mentor as a Word document attached to an email constitutes
authorization for assessment.
OFFICIAL COURSE DESCRIPTION (insert the description from the course catalog of the
college/university.)
Explain how what you learned in the course developed this competence. Review the
requirements for the competence carefully to be sure you specify ways in which the course
aligns with those requirements.
How have you used what you learned and/or how might you apply this competence?
Any additional clarifications you want to provide to substantiate this application.
Mentor/Professional Advisor Approval for Assessment
FACULTY MENTOR: Submit as a Word document by email; that electronic submission will
constitute verification of your approval.
If reviewed by the Professional Advisor:
PA Signature:
Date:
Emailed form from PA account constitutes signature.
The mentor or PA will submit this to the Transfer Coursework processing system by email. It
will be assigned to an assessor. Upon completion of the assessment, we will inform you and
Course Transfer Assessment Form
Updated May 2011
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the mentor of the decision using the assessment form on the next page.
Course Transfer Assessment Form
Updated May 2011
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FOR USE BY SNL ASSESSORS ONLY
__________________________________
Assessor Name
_________________________
Date
ASSESSMENT:
_____ Approved
_____ Not Approved
If approved, is this course also to be added to the pre-approved list?
_____yes
_____no
If not approved, check the reason(s) below and state in the notes section any
recommendations or comments.
This course should be applied to a different competence.
o Recommended competence:
o Resubmit with application to that competence.
Course does not focus sufficiently on competence
Course does not meet required level.
Actual course description from college catalog is required. Provide that description and
resubmit with request for application to this competence.
Insufficient credit hours.
The X competence statement must be rewritten to:
increase clarity
address competence specifically and completely
more accurately reflect learning
Clarification or additional information is required as follows:
Notes:
Course Transfer Assessment Form
Updated May 2011
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