Application for Associate of Arts or
Associate of Science Degree
Submit completed form by email to mjcevaluations@mjc.edu
Requirements to complete this form & successfully receive your degree:
• Complete ONE form for EACH degree.
• You must apply in the term in which you expect to complete your degree requirements or you must re-apply.
• If you are a spring applicant and would like your name printed in the commencement program, your
application must be received no later than the rst Friday in March.
• We recommend that you meet with a counselor before applying to ensure you have met all the requirements.
• All correspondence from the Evaluations Oce will be sent to your MJC Student Email ONLY.
Student Information (Please list your legal name):
Last Name: First Name: Middle Initial:
Student ID: w Birthdate: Phone Number:
I am applying for an: AA*
AS*
AA-T*
AS-T*
(Please mark only one box)
*If your major is not shown in the dropdown
menu, please write it in.
Requirements for this degree were/will be completed: Fall Spring Summer Year:
Are you planning to continue your education after receiving your degree?* Yes No If yes, where?
*This question is optional and used for statistical purposes only.
Please include any additional comments for the evaluators to consider. (Examples: If you have a petition in progress, have submitted a course
substitution, are having transcripts sent to MJC from another college, etc.):
I acknowledge the ocial name on record will be used as the name on the degree.
Student Signature: Date:
OFFICE USE ONLY
Not in eVerify eVerify
Comments:
MJC Enrollment Services • 435 College Avenue, Student Services Bldg. 1st Floor • Modesto, CA 95350 • Phone (209) 575-6605
04/2020_sjb
CSU GE
IGETC/ CSU
IGETC/ UC
Total units that may be double-counted:
Number of units student double -counted:
Pending
Complete
Ineligible
GPA
SGRD
MGH
Email
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signature
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