Cerro Coso Community College
Petition for Graduation
Please print all information
Date: Proposed graduation date:
Name on records: Last: First Middle
Previous last name(s) if any:
(The name on your diploma will appear EXACTLY as it appears on your Cerro Coso BanWeb account. To
change your name, complete the General Person Update form in person at the Admissions & Records
office. Changes to name, date of birth, or social security number will require legal picture ID and
supporting documentation.)
Date of birth: Student ID#:
School email address:
Contact phone: Alternate phone:
Do not mail diploma. I will pick up at Ridgecrest campus.
Mailing address with city and zip. (If above is not checked, diploma will be mailed to this address):
Degree(s)/Certificate(s) Requested:
AA-T............................................................... Major:
AS-T ............................................................... Major:
Associate in Arts............................................ Major:
Associate in Science ...................................... Major:
Certificate of Achievement............................ Major:
Job Skills Certificate....................................... Major:
Will you be attending the commencement ceremonies? Yes No
How do you wish your name to appear on the commencement program:
Do you plan to continue at a four-year institution? Yes No
If yes, please indicate the name of the institution:
If no, briefly describe your educational/occupational plans following graduation:
Do you plan to earn another certificate? Yes No Not applicable
If yes, which:
Did you attend class on or around the campus of:
Ridgecrest Bishop/Mammoth Tehachapi/Edwards Lake Isabella Online
Please check here if you are active-duty military or a veteran.
Did you receive any of the following honors or recognition while attending Cerro Coso?
Not applicable Honors Graduate Honors Program Phi Theta Kappa
Transcripts from all colleges attended must be in the Admissions & Records office before a graduation
petition can be processed.
Student signature: Date:
click to sign
signature
click to edit
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