Prior Learning Assessment: Self-Assessment Form

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Prior Learning Assessment: Self-Assessment Form
Full-Time
FCAPS
Student Number
Student Name
Course/ Program Name:
Course/ Program Code:
PLAR pre-application checklist.
I am 19 years of age or older OR I have an OSSD or equivalent
Yes
No
The course I am interested in is eligible for PLAR (check course outline)
Yes
No
This is my first application OR it has been one year (or longer) since I last attempted PLAR for this course
Yes
No
I have NOT failed or withdrawn from this course in the last year
Yes
No
If you answer “Yes” to all of these questions, you may proceed with your PLAR application
Critical Performance Statement
Learning Outcomes
For each learning outcome listed, please self-evaluate your competency levels and record in the appropriate column.
1. I am able to demonstrate the learning outcome well enough to teach it to someone else.
2. I can work independently to apply the learning outcome.
3. I need some assistance in using the outcome.
4. I am developing skills and knowledge for this area.
5. I have no experience with the outcome.
Level of Competence
Learning Outcomes
Experience ( eg Volunteer, hobbies,
1.
2.
3. Need
4. In
5. No
Documentation/ Evidence
project development)
Demo
Apply
Help
dev.
exp
Advisor Name: ________________________________
Signature: ____________________________________ Date: ___________________
Program Coordinator ____________________________________ Signature: ____________________________________ Date: ___________________
Referred to: Assessor ____________________________________
Bring the completed self-assessment to a consultation meeting with the program coordinator or faculty member.

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