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Application for Exemption from Semester 1 modules (Form 4FAD02)
Application for Exemption from Semester 1 modules (Form 4FAD02)
Application for Exemption from Semester 1 modules (Form 4FAD02)
Application for Exemption from Semester 1 modules (Form 4FAD02)
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Application for Exemption from Semester 1 modules (Form 4FAD02)

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Deadline for submitting your application form signed off by your course co-ordinator is Wed 9 October 2013. Signed forms should be submitted to Margaret Davis in Block F . Unsigned forms will be …

Deadline for submitting your application form signed off by your course co-ordinator is Wed 9 October 2013. Signed forms should be submitted to Margaret Davis in Block F . Unsigned forms will be returned to you thus delaying the process for you. For further information refer to document 3AD06 on the intranet.

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  • 1. Application for exemption from modules based on prior certified or experiential learning Student Name:…………………………………………… Application for exemption from modules based on prior certified or experiential learning File Location: Current Revision: 07 4FAD02 Approved by: Registrar 20 December 2007 Document Owner: AA&SAM 4FAD02.07 Document Level: 4 Application for exemption from modules based on prior certified or experiential learningRevision HistoryRevision Date Revision Description DCRT# Originator01 04 September 03 Conversion of FM129 Lisa Whelan02 17 September Revisions based on Admissions sc Diarmuid O’Callaghan 2004 meeting 2 September 200403 16 May 2006 Revisions based on Admissions sc AA&SAM meeting 16 May 200604 16 October 2006 Revisions based on Admissions sc AA&SAM meeting 16 October 2006 – signature of course coordinator; reference to 3AD06 and 3AD0705 14 February 2007 Revision based on Admissions sc AAO meeting 16 October 2006 – table added to capture if exemptions were previously received.06 23 February 2007 Revision based on Admissions SC AA&SAM meeting on 19 February 2007 – inclusion of Appendix 107 20 December Minor layout revisions to aid clarity of AA&SAM 2007 application4FAD02 Page 1 of 4 07 20 December 2007
  • 2. Application for exemption from modules based on prior certified or experiential learning Student Name:…………………………………………… Currently registered students of IT Blanchardstown who wish to apply for an exemption from one or more modules should use this form. This form should be returned to the Registrar, IT Blanchardstown, Blanchardstown Road North, Dublin 15, before the first Monday of week 3 of the semester in which exemptions are being requested. Relevant certificates should be attached; these will be returned at a later date. While waiting to hear the results of this application, students should continue to attend classes Please note that decisions will be made on the basis of the material provided. Incomplete applications are unlikely to result in granting of exemptions. Students are advised to read documents “3AD06 Exemptions from modules based on prior certified or experiential learning”, and “3AD07 Policy document on prior experiential learning”, prior to submitting an application for exemptions. Appendix 1 can be used for guidance on the information required to support an application for exemptions.Student NameStudent AddressStudent ID NumberCourse for which exemptions are soughtCourse code BNCurrent year of courseYear of course in which exemptions are soughtModules for which exemptions are sought: Module code Module namePlease state reason(s) for making the application {In the case of application on the basis of prior certified learning, a copy ofcertificates relating to learning outcomes of modules must be attached; in the case of prior experiential learning, evidence ofmeeting the learning outcomes of a module must be provided in the form of a portfolio, including a logbook, review of experiencesand workplace supervisor reports}. (add extra pages if necessary)4FAD02 Page 2 of 4 07 20 December 2007
  • 3. Application for exemption from modules based on prior certified or experiential learning Student Name:……………………………………………Modules for which exemptions were sought at ITB previous to this application Module code Module name Approved Semester / Year Yes / NoSigned by student: Date:I have reviewed this application and all supporting documentation, and I support the student’s application.Signed by academic: Date:(this form must be signed by the course co-ordinator of the course on which exemptions are being sought)4FAD02 Page 3 of 4 07 20 December 2007
  • 4. Application for exemption from modules based on prior certified or experiential learning Student Name:……………………………………………APPENDIX 1:Suggested template to aid demonstration of meeting learning outcomes through prior certified orexperiential learningNotes:  Part 1 should be repeated for each module for which exemptions are being sought.  Each section of Part 2 should be repeated, as appropriate, to cover all the learning outcomes in the module syllabusPART 1:Details of exemptions soughtCourse TitleCourse CodeYear of CourseModule TitleModule CodePART 2:Learning outcome – as per module syllabusCertified Learning (list all relevant training undertaken; attach all certificates received)Course titleDate completedDurationContentExperiential LearningGive detailed account of relevantwork experience, e.g., the durationof such experience, the positionheld when such experience wasgained, how it has assisted you inmeeting the listed learningoutcome //ends4FAD02 Page 4 of 4 07 20 December 2007

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