Fillable Ccs 9145 Form 9145 (Spokane Community College)

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Ccs 9145 Form 9145 (Spokane Community College)

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CCS 9145 (Rev. 08/17
Marketing and Public Relations
Spokane Community College * Spokane Falls Community College
PETITION FOR HIGH SCHOOL DIPLOMA
In compliance with RCW 28B.50.535 and 2007c 355 s2, you must have been awarded a degree by either Spokane Community
College or Spokane Falls Community College to petition for a Community Colleges of Spokane high school diploma.
PETITIONER’S NAME (as it is to appear on the diploma) $20 Fee required. Take to cashiers.
Last name:
Middle name:
Previous name(s):
STUDENT IDENTIFICATION NUMBER:
DATE OF BIRTH:
MONTH
DAY
YEAR
LAST HIGH SCHOOL ATTENDED:
City:
State:
ZIP:
Date Community College Degree Received:
/ /
MONTH
DAY
YEAR
COMMENTS:
PETITIONER’S SIGNATURE:
REQUIRED
DATE:
CURRENT ADDRESS:
Street Address/PO Box:
City:
State:
ZIP:
TELEPHONE NUMBER:
E-MAIL ADDRESS:
FOR REGISTRAR USE ONLY
DEGREE
Posted:
AA AAS AST Yr/Qtr
SFCC SCC Initials
UA Coding
Program Code
Exit Code
Fee Attached
(07 Fee Code)
Have all financial obligations been met?
Date diploma sent:
/
/20
MONTH
DAY
YEAR
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Ccs 9145 Form 9145 (Spokane Community College)

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Completed 28 July 2020

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