APPLICATION FOR CERTIFICATE OF ACHIEVEMENT
(Submit a separate application for each certificate)
NAME SID#
PRINT as you wish it to appear on your certificate
EMAIL ADDRESS:
ADDRESS you want certificate mailed to:
City State Zip
YEAR & QUARTER in which you expect to complete the requirements:
Year Fall (Dec.) Winter (March) Spring (June) Summer (Aug.)
This certificate is from the GHC catalog year
Type of certificate for which you are applying
STUDENTS MUST RECEIVE A CUMULATIVE GPA OF 2.0 OR HIGHER
IN ALL REQUIRED CERTIFICATE OF ACHIEVEMENT COURSES
All Position Pipe Welding
Automotive Technology Levels 1-6
(please specify level number applying for)
Baking and Pastries
Basic Food Service
Basic Small Business Skills
Bookkeeping
Carpentry, Beginning
Carpentry, Advanced
Commercial Transportation & Maintenance
Diesel Technology Levels 1-5
(please specify level number applying for)
Early Childhood Education:
( ) Initial State Certificate
( ) Short State Certificate of Specialization:
( ) General
( ) Infants and Toddlers
( ) School Age Care
( ) Family Child Care
( ) Administrative
Energy and Innovation Entrepreneurship
Formatting/Publishing Business Docs
US Veteran Yes No
Member of Phi Theta Kappa Yes
No
Student Signature Date
Industrial Welding
Introduction to Human Services
Meat, Poultry, Seafood Preparation
Medical Coding
Medical Transcription (before 2014)
Microcomputer Applications
Microsoft Office Applications
Nursing Assistant Training
Office Professional Certification
Open Root Pipe Welding
Pipe Welding Basics
Retail Bookkeeping (before 2014)
Retailing (before 2014)
Software Applications
Sustainable Landscaping/Gardening (before 2014)
Welding Basics: Level 1
Welding Basics: Level 2
FOR OFFICE USE ONLY
Approved: YES NO
Date: By:
GPA:
Comments:
REV: 10/15
