Application for Academic Credit of College Course

Instructions: Documentation for all college courses must be submitted for approval with this form and fee*  before you apply for recertification. College credits will be granted NAHUC contact hours per established conversion criteria: 1 credit hour equals 3 NAHUC contact hours. Please note: only 33% (12 contact hours) of the total contact hours for recertification can come from this category.

*Fee: There is no charge for this service for NAHUC members. Non-members must submit $10 (U.S. Dollars) check or money order payable to NAHUC with each submission of Application for Academic Credit.

Name:     Cert #: Cert Yr:
Address:  Telephone #
City:    State/Province: Zip: 
Country: 
E-mail:	 

Attach:        Documentation of Academic Credit for College Courses
                   Fee (non-members)

 Mail to:    NAHUC Certification Board
                 1947 Madron Road
                 Rockford, IL 61107-1716

Members may fax to 815-633-4438.

If you have any questions, please call 1-888-22-NAHUC.

Section II. - Do not write in this section

Number of Academic Credits     _________________

Total Contact Hours                   _________________

Contact Hour Certificates sent__________ By_______________________________