Applicant`s first name and surname (in capital letters):	
Name of the host institution:	
	
Filled in before studies as a visiting student 	Filled in after studies as a visiting student 	
Filled in by the student (part A)	Filled in by the RPL committee	Filled in by the student (part B)	Filled in by the RPL committee	
Course/module of the  UT curriculum	Planned course/module	Decision	Course/module completed	Confirmation**	
Requested course, course code, volume, module / module, volume 
	Name of course/module in Estonian and English 	Code	Volume
(ECTS)	Argumentation**	Course/
module category*	NOT completed	Grade	Date	First and surname of teaching staff member 	Enter to SIS	Grade	

		
				Name, signature, date:						Signature:	

		
				Name, signature, date:						Signature:	

		
				Name, signature, date:						Signature:	
*Course category: 1 – compulsory course in major specialisation; 2 – elective course in major specialisation; 3 – copmulsory course in minor specialisation; 4 –elective course in minor specialisation; 5 – optional courses;
Module category: B – base module; F – field module; S – specialisation module; E – elective module; O –optional courses 
** Argumentation/decision may be filled in by the RPL committee of another curriculum if needed.