CSU GE/IGETC Certication
Submit completed form by email to MJCevaluations@mjc.edu, in-person, or mail to Enrollment
Services. Electronically signed forms will ONLY be processed when using your MJC Student Email.
Today’s Date:
CSU GE/IGETC certication will be completed by Enrollment Services only after ocial grades are posted for the
completion of the student’s last semester in attendance at MJC, prior to transferring to the CSU/UC. Please allow 5-7
business days for processing, plus additional mailing time.
ONLY complete and submit this form if you meet all of the following requirements:
1. You have been accepted to a four-year college or university and
2. The college/university has requested the certication and
3. All courses have been completed and grades posted.
If coursework from other institutions (high school, college, or universities) needs to be applied to this
certication, Ocial Transcripts must be on le with the Enrollment Services oce prior to submitting this
form. This includes UC foreign language requirements and/or AP/IB scores.
Student Information:
Last Name: First Name: Middle Initial:
Student ID: w Birthdate: Phone:
Email:
Which GE Pattern are you requesting certication for? Check only one.
CSU GE IGETC (CSU version) IGETC (UC version)
College/University to send the certication to:
Name (College/University):
Mailing Address:
By signing below I understand I am giving consent for MJC to send my certication to the College/University I listed above.
Student Signature: Date:
Oce Use Only
Sta Initials: Date: Full Partial Student Notied:
Comments:
04/2019_SJB
MJC Enrollment Services • Phone (209)575-6605
Ea st 435 College Avenue, Student Services Bldg. 1st Floor • We s t 2201 Blue Gum Avenue, Yosemite Hall 1st Floor
click to sign
signature
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