\\ccmanzan2\cte\H.S. Articulation Agreements\Forms\Certificate of Student Completion of Articulated Course.docx
Certificate of Student Completion
of Articulated Course
Completed by High School Instructor and Student
High School/ROP: _____________________________________________________________________
High School ROP Administrator signature: __________________________ Date: __________/________/______
High School Instructor signature: __________________________ Date: ______/_______/________
Course Articulation Information
High School/ROP Course Information:
Course Name: _______________________________________________________________
Course Number: ____________________________ Final Grade: ______________
Columbia College Course Information:
Course Name: _______________________________________________________________
Course Number: ____________________________ Units: __________
Directions to each high school student:
In order to receive college credit for this course, complete the student information below and submit a college application.
Student that will graduate in 2013, please print the sheet that states “Submitted Electronic Application” and attached to
this form and send to address listed below. Students not graduating in 2013, please print signature page and attached to
this form and send to the address listed below.
Mail to: Jean Mallory, CTE Transition Coordinator
11600 Columbia College Drive, Sonora, CA 95370
Student Information
Student Name: _________________________________________________Age:_________________
Student Address: ______________________________________________________________________
Phone Number: ______________________________________________________________________
Last 4 digits of Social Security Number: __________
Student date of graduation from high school: ____/____/______
Parent Signature ____________________________________________
(Required for students under the age of 18)
College Action
College Division: Verified Recorded
Dean of Instruction signature: __________________________ Date: _____/_____/_______
CTE Transition Coordinator: ___________________________ Date: _____/_____/_______
Admissions and Records: Admissions Office signature: ___________________________ Date: _____/_____/_______
Directions to each high school instructor:
1. Use a separate form for each course and student.
2. Complete both high school and college information
