Course Credit Request Form
Students wishing to receive credit for any non-accredited high school course(s) will be required to complete two steps: 1) Complete this form with the required information for each COMPLETED course they wish to transfer in; 2) Take a placement exam for any core courses (Math, Science, English, History) taken during the most recent academic year.

Ex: Your child wants to transfer to NSA as an 11th grader and has completed home school up through 10th grade. For each course taken in 9th grade and 10th grade, a Credit Request Form must be completed. For the four core courses taken in 10th grade, your child must take a placement exam and receive a 70% or better. Note: The Homeschool or non-accredited course grade will be listed on the transcript (not the placement exam score).

Please contact the guidance office (guidance@northstar-academy.org) if you have questions about this form.

Student Name *
Your answer
Parent/Guardian/Supervisor Name: *
Your answer
Parent/Supervisor Email *
Your answer
School Year Course was completed *
Please only submit a course credit request form if the student has already completed the course. Do not submit a course credit request form for a course that is planned or in-progress.
Your answer
Course Name (Please only list one course per form) *
Your answer
Course Description *
Your answer
Instructor Name *
Your answer
Instructor Credentials/Certifications *
Your answer
Course Objectives *
Your answer
Course Resources Used *
Your answer
Number of Credits Earned *
Your answer
Grade Earned *
Your answer
Total Number of Direct Contact Instruction Hours (For extracurricular courses only)
***For extracurricular courses, such as piano or ballet, you must include total hours of instruction time; this is not required for all other classes. For example, list the hours the student worked with the instructor directly. Practice time or homework away from the instructor does not constitute direct contact hours. Confirmation of these hours will need to be provided by the instructor. The instructor can email the NSA Guidance Office directly (guidance@northstar-academy.org) with confirmation of these hours, or the instructor can provide confirmation on letterhead and the student's supervisor can forward that on to the NSA Guidance Office .
Your answer
Any Additional Information
Your answer
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