CPL Application

CREDIT FOR PRIOR LEARNING (CPL) APPLICATION
Emergency Medical Technician
To apply for CPL to use toward your certificate or degree at Blue Mountain Community College, you will need to:
1. Complete and submit this form.
2. Attach a copy of your valid State of Oregon EMT license with this request.
3. Pay required fees once application has been approved.
NOTE: To apply for credit you must be a currently enrolled student at Blue Mountain Community College and have completed at least one course at the time of application.

Transcription Fee: $25 per course

Fee will be charged after the completed form has been returned and processed by Enrollment Services. A link to a payment form will be sent via email. Once payment has been received, courses will be transcribed and added to your transcript.
Name

First NameLast Name
BMCC ID
Date of Birth

MonthDayYear
Date
Email Address
example@example.com
CPL Credit Options: Documentation required (see below)
Certification/Credit Options: Indicate below which criteria you meet (select at least one). Documentation Required (see below)
Upload required documentation for the above selection(s)

Cancelof
QUESTIONS? Please contact our EMS Coordinator at 541-278-5786 or Fire Science Coordinator at 541-278-5799.

By completing and submitting this form, I agree to have the above applicable CPL credits applied toward my current certificate or degree program at Blue Mountain Community College. I understand courses will not be transcribed until payment is received.
Student Signature
Date

MonthDayYear
Date
Should be Empty:

CREDIT FOR PRIOR LEARNING (CPL) APPLICATION

Emergency Medical Technician