Clinton Community College Health Studies Certificate Graduation Application
Effective Fall 2017
Completion Term
May: ___
Aug: ___
Dec: ___
Year: _________
ID#: C________________________
Print Name Exactly as Diploma Should Read: ____________________________________________________________
Mailing Address to Send Printed Diploma: _____________________________________________________________
Apt. _________________
City: ____________________________________________
State: _______
Zip Code: ___________________
Phone: ________________________________
Email: _________________________________________________
Ceremony (Check One): Will Attend ___ or Will Not Attend ___
Will attend ceremony short credits (≤ 6 cr.): ___ Will transfer credits back from: ______________________________
Discipline
Credit
Hours
Course Title
Scheduled
Credits
Earned
English
(3 credits)
3
ENG 101English Composition
College Success
(3 credits)
3
FCS 101Foundations for College Success
Science with a lab
(8 Credits)
4
BIO 101General Biology I
4
CHE 101Applied Chemistry
Social Sciences
(3 credits)
3
PSY101Introduction to Psychology
Health & P.E.
(7 credits)
1
HPE 100Seminar in Health Career Pathways
3
HPE 101Personal Health
3
HPE 102Safety & First Aid
Free Electives
(6-8 Credits)
4
MAT100 OR MAT100Q, if required by placement
Total
30-32
Student Signature: _____________________________________________Date:____________________
Advisor Signature: _____________________________________________Date:____________________