Credit Transfer Application Form

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Section 1 – Student & Visit Details

Student Name

Student No

Qualification / Course

Assessor Name

Date

Section 2 – Application and Declaration

I wish to apply for credit transfer for the units of competency/modules listed below.

I have attached original copy of certification documentation from another RTO.

I declare that certification documentation supplied is legitimate, true and correct.

I understand that the Assessor will verify my certification documentation for validity.

Student Signature

Section 3 – Units / Modules Outcome

Unit Code

Unit Name

Evidence Supplied

Evidence Verified

Assessment Outcome

Assessor Initial

Section 4 – Assessor Judgment and Declaration

Declaration

Assessor Signature

Date

Admin Use Only

SMS Updated

Student File Updated

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Credit Transfer Application Form

Section 1 – Student & Visit Details

Section 2 – Application and Declaration

Student Signature

Section 3 – Units / Modules Outcome

Section 4 – Assessor Judgment and Declaration

Admin Use Only

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