Fillable Form 2.: REQUESTFORDEGREEORCERTIFICATE (Chabot College)

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PL:RB08‐13‐2020

Submitormailthisformto:

OfficeofAdmissionsandRecords

25555HesperianBoulevard

Hayward,California94545

Email:ccarcom@chabotcollege.edu

Fax:(510)723‐7510

REQUESTFORDEGREEORCERTIFICATE

ProcessingTime:Approximately16weeks

STUDENTINFORMA T IO N

LastName,FirstName,MiddleInitial: StudentID:

MailingAddress: PhoneNumber:

City,State,ZipCode: E‐mailAddress:

DEGREEORCERTIFICA T EINFORM A T IO N 

Coursesrequiredfordegreeorcertificatewillbeco mple ted: Fall Spring Summer Year:

Iamsubmittingthisrequestforthefollowingdegreeorcertificate:Listofmajors,certificates,andmajorcodesonpage2.

MajorCode

SelectCodefrom

page2

Degreeor

Certificate(AA,

AS,AS‐T,AA‐T,

CA,CP,C)

ForAA/ASdegree,choosea

generaleducationrequirement

pattern:GeneralAA/AS,CSUGE,

IGETCforCSU,IGETCforUC

MajorTitle CatalogYear*

1.

2.

3.

*CatalogYear:

•

GraduationrequirementsarelistedintheChabotCollegeCatalog.

•

YoumaychoosetomeettherequirementscontainedwithinanyChabotCollegeCatalogtowhichyouhave“catalogrights.”

•

Havingcatalogrightsmeansthatyouareheldtothegraduationrequirementslistedinthecatalogatthetimeyourcontinuousenrollmentbeganorinanysubsequent

academicyearduringwhichyoumaintainedcontinuousenrollment.

•

Tomaintaincontinuousenrollment,youmusthaveenrolledinatleastoneterm(fallorspring)eachacademicyear.Anyacademicrecordsymbol(A‐F,P,NP,I,IP,RD,

W)shallconstituteenrollment.NOTE:Ifyoudon’tselectacatalogyearoryouselectonethatyoudon’thavecatalogrightsto,

acatalogyearwillbedeterminedforyou.

3. Iattendedothercolleges/universities: Yes No

Ifyes,listallcollegespreviouslyattendedandselectwh etherofficialtranscriptsareonfileat Chabotorhavebeenrequested.

Approvedcoursewaiverand/orsubstitutiononfilewithAdmissions&RecordsOffice: Yes No NotApplicable

APexamsco

rere

portonfilewithAdmissions&RecordsOffice: Yes No NotApplicable

PreviousCollege(s)Attended NameusedWhileEnrolled

OfficialTranscript



OnfileatChabot Requested



OnfileatChabot Requested



OnfileatChabot Requested



OnfileatChabot Requested

4. Mynameshouldappearasfollowson mydiploma/certificate:

Clearlyprint.Unclearprintingwillreproduceamisspelledname.Reprintchargeis$20fordegree,$10forcertificate.

FirstName MiddleNa

me LastName

PLEASEREADANDINITIALBEF ORESIGNING

Iunderstandthatmyrequestwillonlybecompletedif(a)allmydegree/certificaterequirementswillbecompletedbytheendofthecurrentterm

or(b)allmydegree/certificaterequirementshavealreadybeencompleted.

IunderstandthatifIwishtotransferacademiccreditforcoursestakenatotheraccreditedcolleges/universities,Imustsubmitofficialtranscriptsofthatcourseworkto

theAdmissionsandRecordsOffice.Failuretosubmitallofficialtranscriptswillresultinmydegreerequestbeingreturnedtome.IunderstandthatifIwishtousecredits

earnedfromanoutofcountrycollege/university,transcriptsmustbeevaluatedbyaforeigntranscriptevaluationservice.Courseworkfromanoutofcountry

college/universitycannotbeappliedtoCSUGEBreadthandIGETCrequirements.

Iunderstandthatallfinancialholdsmustbeclearedbeforemyrequestwillbecompleted.

IunderstandthatIwillreceivearesponsetomyrequestinapproximately16weeksviapostalmail.Ifthereareanyissueswithmyrequest,Iwillbecontacted

throughtheemailprovidedonthisform.

Iunderstandthatinordertobeissuedadegreeorcertificate,studentsearningacertificate,AssociateinScience,orAssociateinArtsdegreeinan

Occupational/Technicalareamustcompleteaminimumof12unitsinresidencyatChabotCollegewithinthedegreemajororcertificateprogram.

IunderstandthatIwillbeawardedaCertificateofAchievementinCSUGEBreadthandIGETCCSUifIhavecompletedallrequirementsforanassociatedegreefor

transfer.

I understand that if I am requesting an AA‐T or AS‐T and my requested GE pattern does not match the GE pattern that I previously declared, my declared major/GE

patternwillbeupdated inmyofficialcollegerecordtomatchthisrequest.Similarly,IunderstandthatifIamrequestingamajorandmyrequesteddegreetype(AAor

AS) does not match the degree type thatI previously declared for thatmajor, my declaredmajor/degree type willbe updated inmy officialcollege record to

matchthisrequest.(E.g.,AAinFireTechnologyvs.ASFireTechnology.)

Iunderstandthatfailuretocompletethisforminitsentiretywillresultinmyrequestbeingreturnedtome.

StudentSignature: Date:

OFFICEUSEONLY

Datedegreeawarded:

 Honors:

GPA3.25to3.49

HighestHonors:GPA3.50to4.00

Requestrecorded: EvaluatedBy:

MAJOR / CERTIFICATE TITLES (GRADUATION REQUEST)

AA-T DEGREE

2238 Anthropology (CSU GE) 2261 History (IGETC CSU) 2265 Social Justice: Asian American Studies (CSU GE)

2239 Anthropology (IGETC CSU) 0608 Journalism (CSU GE) 2266 Social Justice: Asian American Studies (IGETC CSU)

1512 Communication Studies (CSU GE) 0609 Journalism (IGETC CSU) 2267 Social Justice: Chicano Studies (CSU GE)

1513 Communication Studies (IGETC CSU) 0828 Kinesiology (CSU GE) 2268 Social Justice: Chicano Studies (IGETC CSU)

2244 Economics (CSU GE) 0829 Kinesiology (IGETC CSU) 2145 Social Work and Human Services (CSU GE)

2245 Economics (IGETC CSU) 1038 Music (CSU GE) 2146 Social Work and Human Services (IGETC CSU)

0027 Elementary Teacher Education (CSU GE) 1039 Music (IGETC CSU) 2229 Sociology (CSU GE)

0028 Elementary Teacher Education (IGETC CSU) 2228 Political Science (CSU GE) 2234 Sociology (IGETC CSU)

1518 English (CSU GE) 2233 Political Science (IGETC CSU) 1108 Spanish (CSU GE)

1519 English (IGETC CSU) 2003 Psychology (CSU GE) 1109 Spanish (IGETC CSU)

2231 Geography (CSU GE) 2004 Psychology (IGETC CSU) 1037 Studio Arts (CSU GE)

2232 Geography (IGETC CSU) 2252 Social Justice Studies: Ethnic Studies (CSU GE) 1041 Studio Arts (IGETC CSU)

2269 Global Studies (CSU GE) 2253 Social Justice Studies: Ethnic Studies (IGETC CSU) 1036 Theatre Arts (CSU GE)

2270 Global Studies (IGETC CSU) 2263

Social Justice: African American Studies (CSU GE)

1040 Theatre Arts (IGETC CSU)

2260 History (CSU GE) 2264

Social Justice: African American Studies (IGETC CSU)

0014 Administration of Justice (CSU GE) 2199 Early Childhood Education (CSU GE) 1921 Physics (CSU GE)

0015 Administration of Justice (IGETC CSU) 2133 Early Childhood Education (IGETC CSU) 1922 Physics (IGETC CSU)

0411 Biology (CSU GE) 1704 Mathematics (CSU GE) 1233 Public Health Science (CSU GE)

0412 Biology (IGETC CSU) 1705 Mathematics (IGETC CSU) 1234 Public Health Science (IGETC CSU)

0572 Business Administration (CSU GE) 1308 Nutrition and Dietetics (CSU GE)

0575 Business Administration (IGETC CSU) 1309 Nutrition and Dietetics (IGETC CSU)

2101 Administration of Justice 1077 Fine Art Ceramics 4923 Liberal Arts-Opt I Social/Behavioral Sci.

2230 Anthropology 1078 Fine Art Painting and Drawing 4924 Liberal Arts-Opt I Math/Science

0201 Architecture 1127 Fine Art Photography 4932 Liberal Arts-Opt I Kinesiology/Wellness

1043 Art History 1079 Fine Art Sculpture 0603 Mass Communications

2008 Behavioral Science 1080 Fine Art Studio Foundations 1701 Mathematics

0402 Biology 1102 French 0605 Radio and Television Broadcasting

0403 Biology (Emph. in Allied Health) 4960 Humanities 0519 Real Estate

2105 Early Childhood Development 2205 Geography 2262 Social Science

2130 Early Childhood Intervention 1094 Graphic Design 1105 Spanish

1508 English (Emph. in Literature) 4903 International Studies 1505 Speech Communication

0304 Environmental Studies 0601 Journalism 1008 Theater Arts

2203 Ethnic Studies 4919 Liberal Arts-Opt I Arts/Humanities

0620 Film and Animation 4920 Liberal Arts-Opt I Comm. English Lang.

0501 Accounting 0770 Computer Science 0586 Information Technology

1910 Advanced Manufacturing Technology 1200 Dental Hygiene 0204 Interior Design

0987 Auto Technology (Emph. in Chassis) 0994 Electronics Systems Technology 1243 LVN-RN

0988 Auto Technology (Emph. in Drivetrain) 0922 Engineering 0939 Machine Tool Technology

0990 Auto Technology (Emph. in Engine Performance) 0576 Entrepreneurship 1702 Mathematics

0986 Auto Technology (Emph. in Maintenance) 0305 Environmental Science 1244 Medical Assisting

0547 Business (Emph. in Management) 2129 Fire Prevention Inspector 0941 Numerical Control

0548 Business (Emph. in Marketing) 2128 Fire Technology 1230 Nursing

0549 Business (General) 2221 Human Services 0750 Software Specialist

1902 Chemistry 0935 Industrial Technology 0953 Welding Technology

0525 Accounting Technician 2131 Early Childhood Intervention Assistant 0593 Intl. Entrepreneur-Spanish

0527 Administrative Assistant 9014 ESYS: Consumer Technology 1528 Interpersonal Communication

1912 Advanced Manufacturing Technology 9015 ESYS: Industrial Electronic Technology 1128 Italian

0619 Animation 1307 Family Child Care Entrepreneur 1112 Japanese

0809 Aquatics 0621 Filmmaking 0211 Kitchen and Bath Design

0213 Architecture Technology 2153 Fire Fighter Academy 0940 Machinist

2271 Asian American Studies 1110 French 0544 Management

0974 Automotive Chassis Technology 2127 Fire Prevention Inspector 0538 Marketing

0978 Automotive Maintenance Technology 2126 Fire Technology 1205 Medical Assisting

0035 Automotive Service Consulting 0811 Fitness Instructor 0942 Numerical Control Programmer (Machinist)

0564 Bookkeeping 1092 Graphic Design 1402 Paralegal Studies

5001 Business Administration 1091 Harmony & Musicianship 0837 Pathway to Sports Injury Care

2272 Chincanx and Latinx Studies 5002 Health Care Administrator 1529 Persuasive & Rhetorical Comm.

1125 Chinese 1216 Health Information Coding 1530 Public Speaking and Forensics

0810 Coaching 0565 Human Resources Assistant 0589 Real Estate Broker

2400 Computational Design 0036 Hybrid & Alternative Fuel Vehicles 0556 Retail Management

4927 CSU General Education Breadth 4944 IGETC (CSU GE) 0552 Small Business Management

1237 Dental Radiation Safety 4928 IGETC (UC) 0757 Software Specialist

0622 Digital Media Arts 2150 Infant/Toddler Specialist 1113 Spanish

1074 Digital Photography 0581 Information Technology 4959 Student Support Leader. (Tutoring)

2147 Early Childhood Administration 1310 Interior Design (Residential) 2401 Techical Design Drafting

2149 Early Childhood Curriculum Specialist/TK 1126 Intl. Entrepreneur-Chinese 0949 Tool Maker

2152 Early Child Dev. (Associate Teacher) 0591 Intl. Entrepreneur-French 2254 Women's Studies

2118 Early Childhood Dev. (Basic Teacher) 0592 Intl. Entrepreneur-Japanese

0594 CPA Exam Prep: Audit. & Attest. 2220 Geographic Information Systems 0569 Real Estate Entrepreneur

0595 CPA Exam Prep: Bus. Env. & Con. 0979 Inspection and Pipe Welding 0529 Retailing

0596 CPA Exam Prep: Fin. Acc. & Rep. 1014 Photography 0030 Technical Design

0597 CPA Exam Prep: Regulation 0574 Project Management 0952 Welding

1531 Creative Writing 0590 Real Estate Agent

nea 12-7-20

AA DEGREE

AS-T DEGREE

CERTIFICATE OF ACHIEVEMENT

AS DEGREE

CERTIFICATE OF PROFICIENCY

(NOT TRANSCRIPTED)

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Completed 2 February 2021

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