Archway Online: Elective Credit Acceptance Application
Please submit for each elective course you are wanting verified for credit.
Student Name
*
First Name
Last Name
Teacher of Record Name
*
First Name
Last Name
Today's Date
*
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Month
-
Day
Year
Date
Name of Course
*
Course Scope and Sequence Summary: Scope, Sequence, Content Outline, Curriculum Provider, etc.
*
Course Start Date
*
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Month
-
Day
Year
Date
Course End Date
*
-
Month
-
Day
Year
Date
Average number of hours per week student spent on class:
*
Total numbers of hours student spent on class:
*
Attendance or Activity Log, including a description of objectives covered or activities performed:
*
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of
Completion artifact: Examples: Short research paper related to content, summary of participation, final assessment results, assignment example, etc.
*
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of
By signing this form, I certify that I am the teacher of record as named above and all information provided is accurate and true:
Submit
Should be Empty: