Credit By Examination Request

Credit By Examination Request
Name:

First NameLast Name
Student ID:
Date of Birth:

MonthDayYear
Date
Phone Number:
Please enter a valid phone number.
I request credit for the following course(s):
Course Course
Course Course
My request is based on the following official test scores which I have provided to Panola College:    ACT    AP   CLEP   IB   SAT

Date taken:      Score   Grade
Date taken      Score   Grade
Date taken    Score    Grade
I have read the policies and understand the stipulations concerning my request. Policies can be found at https://www.panola.edu/admissions/requirements. Signature:

Clear
Should be Empty: