Fillable AA AS Grad AppFILL2 (Mission College)

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AA AS Grad AppFILL2 (Mission College)

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APPLICATION FOR DEGREE
Associate in Arts/Associate in Science
Admissions & Records Office, 3000 Mission College Blvd, Santa Clara, CA 95054-1897
Name
Student ID:
First
Middle
Last
(Print your name as it is to appear on the degree)
Address
Home Phone:
Street
Other Phone::
State
Zip
Courses required for the degree will be completed: Year: ____ Fall Spring Summer
AA Major:
AS Major:
GE Pattern: AA/AS CSU GE-B IGETC
NOTE: Completion of either of the CSU GE-B or IGETC pattern qualifies you for a Certificate of
Achievement. Complete the Application for Certificate.
1. Have you taken a course(s) from another institution(s)?
Yes No
2. In order to provide a prompt evaluation of your petition, list all colleges previously attended and
the date you requested your transcript sent to Mission College
PREVIOUS COLLEGE(S) ATTENDED
NAME USED WHILE ENROLLED
DATE TRANSCRIPT
REQUESTED
3. List Course Substitution: approval must be obtained by Major Department Chair.
COURSE
SCHOOL WHERE
COURSE(S) WAS TAKEN
SUBSTITUTE FOR MISSION
COLLEGE COURSE
DEPARTMENT CHAIR SIGNATURE
4. How did you meet the Reading Proficiency Requirement?
Reading 054 course
 Proficiency Exam  Course from other college
5. How did you meet the Information Competency Requirement?
LIB 010  Proficiency Exam  Course from other college
6. INTERNATIONAL STUDENTS: This application must be signed by a Designated School Official (DSO)
DSO Print: Signature: Date:
Student Signature: Date:
REQUIRED: Complete the worksheet on Page 2
Name: SID#:
Last Name, First Name
AA/AS
All Official Transcripts that apply to your degree must be on file in the Records Office
or your Application for Degree will be DENIED
AA/AS DEGREE WORKSHEET
List completed and current courses taken to satisfy each GE area. NOTE: All GE areas must be complete in order to qualify for AA or AS.
AA/AS General Education Requirements
Completed
Courses
Current
Courses
Institution
Categories
Area A – Language & Rationality 2 courses, 6 units minimum
EXAMPLE:
ENGL 001A
MISSION
A1. Written Communication
A2.
Area B – Natural Science 1 course, 3 units minimum
Area C –Humanities 1 course, 3 units minimum
Area D - Social & Behavioral Sciences 2 courses, 6 units minimum
D1. HIST or POLIT
D2.
Area E - Lifelong Learning 1 course, 3 units minimum
FOR OFFICE USE ONLY
UA
UC
PTS
GPA
APPROVED
MC/WVC
DENIED
Other Colleges
DIPLOMA SENT
Military
Comments:
Subtotal
Current
OVERALL
TOTALS
Major & Related Courses
Major:
Completed Courses
Current Courses
Institution
Graduation Proficiency Requirements
Requirement
Completed
Course
Current
Course
Institution
Writing
Reading
Mathematics
Communication
Information Competency
Counselor Comments (optional):
Counselor Initials:
Date:
Name: SID#:
Last Name, First Name
See attached Curriculum Guide
Page 2
SID#:
BELOW FOR RECORDS OFFICE USE ONLY
General Education Courses
Major & Related Courses
Courses
Current
Institution
Catalog Year
Categories
Completed
Courses
Units
A. Language & Rationality
.
.
Courses
Completed
Current
English (SP05)
.
.
.
.
Reading
.
.
.
.
Math
.
.
.
.
Comm (SP05)
.
.
.
.
Info Comp (FA06)
.
.
.
.
B. Natural Science
.
.
.
.
.
.
.
.
C. Humanities
.
.
.
.
.
.
.
.
D. Social Science
.
.
.
.
Hist/Polit
.
.
.
.
Other
.
.
.
.
E. Lifelong Learning
.
.
.
.
.
.
.
.
TOTAL:
.
.
.
.
.
.
.
.
Units
Units
Grade
.
.
Attempted
Completed
Points
GPA
.
.
MC / WVC
.
.
College
.
.
.
.
.
.
Other
.
.
Colleges
.
.
.
.
.
.
Military
.
.
(DD214)
.
.
.
.
.
.
Subtotal:
.
.
.
.
.
.
.
.
Current:
.
.
.
.
.
.
.
.
TOTAL:
.
.
.
.
.
.
.
.
Final
Remarks:
GPA:
Final
Approval:
Diploma
Sent:
Denied:
MCAO 111816
Page 3
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AA AS Grad AppFILL2 (Mission College)

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Completed 26 July 2020

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