Credit for Prior Learning Request Form

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Credit for Prior Learning (CPL) Request Form

Your full name:

Your student ID number:

Your program name:

Enter the information of the class you are interested in for CPL:

Class name:

Class catalog number:

Student Acknowledgement:

I understand that the $90 CPL fee is non-refundable and non-transferable.

I understand that I must complete my CPL assessment within 90 days after making my payment. Failure to complete it will result in my having to submit a new assessment form and making a new payment.

I understand that I will only receive the CPL credits if I pass the assessments.

I certify that I have not taken the assessment or class previously at Lakeshore College.

Student Signature:

Date:

For staff use only:

Staff stamp for payment received:

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