<p> PETITION ASSESSMENT FORM (Prepare two forms for each petition one for each evaluator)</p><p>TO BE COMPLETED BY THE STUDENT Student Name: ID#:</p><p>COURSE PETITION: Prefix: Number: Title:</p><p>TO BE COMPLETED BY THE EVALUATOR</p><p>ASSESSMENT CONSIDERATIONS Please circle the following: (5) Strongly Agree, (4) Agree, 3) No Comment, 2) Disagree, (1) Strongly Disagree Course Prefix: 1-2-3-4-5 (a) Prefix coincides with the Title and Course Description. Course Number: 1-2-3-4-5 (a) Number is appropriate for the level of credit requested in the petition. Course Title: 1-2-3-4-5 (a) Title is descriptive of the course content. Course Description: 1-2-3-4-5 (a) The content of the course description is sufficient for the level of credit requested. 1-2-3-4-5 (b) The course description is adequately related to the student’s major. 1-2-3-4-5 (c) The course description is significantly different from others in the portfolio. Concrete Experience: 1-2-3-4-5 (d) The concrete experiences are adequate for the knowledge the student is claiming. 1-2-3-4-5 (e) The concrete experiences are related to the Course Description. Learning Outcomes: 1-2-3-4-5 (f) The learning outcomes are sufficient to support credit hours requested. 1-2-3-4-5 (g) The student adequately described WHAT was learned. 1-2-3-4-5 (h) The learning outcomes are related to the concrete experiences presented. 1-2-3-4-5 (i) The petition has an adequate balance between practical and theoretical knowledge. Applications and Implications for New Situations: 1-2-3-4-5 (j) Learning was applied to situations other than those in which it was acquired. 1-2-3-4-5 (k) Learning applies conceptually to future situations. Documentation: 1-2-3-4-5 (l) Documentation is adequate and supports the petition. General: 1-2-3-4-5 (m) Writing proficiency is adequate for the level of credit requested with this petition. 1-2-3-4-5 (n) Ability to express ideas was adequate for the level of credit requested in this petition.</p><p>RESULTS 1. ACCEPT The petition for credit as requested. (Comment below if desired) 2. DENY The petition for credit. (PLEASE COMMENT BELOW) 3. ADJUST The petition to reflect the following; (PLEASE COMMENT BELOW) Change PREFIX to: ______Change COURSE LEVEL to: (Please Circle) 1000 2000 3000 4000 Change TITLE to: ______Reduce HOURS REQUESTED to: (Please Circle) 1 2 3 Combine this petition with petition(s) ______and ______and call it: ______(Prefix) (Number) (Title) COMMENTS:</p><p>Evaluator’s Initials______</p>