For Statewide & Local
Articulation Agreements
Petition for Award of
Articulated Credit
Students: Complete
and submit this form with an official high school transcript to a participating
public two-year college in
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Student Full Name |
Address |
City |
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State |
Zip |
Area Code / Phone |
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Social Security Number |
High School & District |
Graduation Plan rMinimum rRecommended rDistinguished rHS
Tech-Prep |
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Date of Graduation |
Date of this Application |
Student Signature |
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This section to be
completed by the college
Record of HS State-wide Articulated Courses |
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Course Name & Abbreviation |
Grade Taken 9, 10, 11, or 12 |
Course Grade |
College Equivalent rWECM rACGM |
Date Transcripted |
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Declared College Major |
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Date of college enrollment rDate is within 15 months of HS graduation |
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rStudent has completed additional 6 non-developmental college hours in any area. Indicate if satisfied by Advanced Placement or CLEP examination scores, dual credit or after graduation. |
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Advanced Placement or CLEP |
College Courses (dual credit or after graduation) |
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Course Grade |
Course Grade |
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Course Grade |
Course Grade |
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Signature of college official |
Title Date |
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