Petition Form

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UHM-2007 PETITION FOR BACK CREDITS in LANGUAGES All students (including native speakers of a language) under the current General Education requirements (effective since 2001) with experience in another language other than English may earn “back credits.” These students may take any UHM course, appropriate to their level, in which there is significant use of that language. (Appropriate level determined by placement exam or adviser; significant use determined by the course content.) Upon completion of this course, if students earn a letter grade of C (not C-) or better, they will receive between 3-16 back credits. Name:_________________________________ Student ID Number:_______________________ Last First MI Student’s College:_____________________ Student’s Major: ____________________ Under the current General Education requirements (effective since 2001)? ______ Having completed ___________________with a grade of C (not C-) or better, I request that I be course granted ______ credits in _________________. I previously studied this language language at _____________________________________, ___________________________________. name of school location (U.S. city and state or country) I have not received credits for this language from any university.____________. (Please initial.) I have not received back credits for any other language. ___________. (Please initial.) Student’s Signature:_______________________________________ Date: __________________ I approve the above petition to grant _______ additional credits for the completion of _________________. course name and no. Credit is granted for the following courses: language and course no. __________________________ __________________________ __________________________ __________________________ credits ________ ________ ________ ________ Signed: __________________________________________________________________________ language department chair’s signature date Original to Admissions and Records Copy to LLL Office, Bilger 101

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