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SCHOOL / COLLEGE LETTER HEAD BONAFIDE CERTIFICATE 1. Name of the student : 2. Name of the parent
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Certified that Mr./Miss/Mrs/. S/o/D/o Shri_____________________________________________________________ resident of village/town___________________________Tehsil. Distt. having qualification. has been working in this School since_____________________
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Application for a Degree / Certificate Application for:
Office Use Only STAT H or HH SACP/SGRD
Associate degree Certificate of Achievement Certificate of Accomplishment
FALL SPRING SUMMER
Term:
____________
_________
Staff Initials
Date
Application Deadlines Spring 2018: Mar. 16, 2018
Fall 2017: Oct. 6, 2017
Student ID:
Summer 2018: Jun. 21, 2018
Name: Last
First
Middle Initial
Phone Number:
Email:
We recommend a graduation check appointment with Counseling prior to applying for a degree or certificate. You can make an appointment in person, by phone at 510-659-6110 or on the Counseling webpage. Academic program (major) code: Select a code from page 2 of this form or the current class schedule.
Catalog Year*:
*If this item is blank or the year selected is not appropriate, the academic year in which the application is submitted will be used as the default catalog.
If applying for an associate degree, please select your General Education Pattern: SELECT ONLY ONE: Plan A (Ohlone College General Education) Plan B (CSU General Education Breadth) Plan C (IGETC General Education Transfer Curriculum) *Please only choose ONE: to UC CSU *Plan C for a UC requires a foreign language. If you are using high school coursework, please provide your official high school transcript. **Please note, Transfer degrees must be completed using either Plan B or Plan C for a CSU.
Transfer Work and Graduation Check I am also using coursework from another college or AP scores. Identify colleges: I am using course substitutions or waivers. Identify courses: A counselor has completed a preliminary worksheet for me. Name:
Date:
Commencement and Diploma Information Do you plan to attend commencement? Would you like your name included in the commencement program? (Spring graduation ceremony) Yes No Yes No Yes No Should your middle name be included on your diploma and the program*? *Please note, if your name has changed you must complete a student information change form and submit that to Admissions with the appropriate
documents in order to for it to be reflected on your diploma and/or the program.
Do you plan to pick up your diploma*? If no, please list the address you would like your diploma mailed to: Yes No Street City
Apt. or Unit State
Zip Code
*Please note, diplomas are not given out at the graduation ceremony. They are typically available 8-10 weeks after the end of term. You will be notified by email when your diploma is ready for pickup at the Fremont campus Admissions Office. Rev. 9/2017