Rev. September 2014
Certificate of Achievement
1. Complete this petition (one form per course substitution)
2. Attach supporting documentation (both course description and course syllabus are required). Official transcripts
must be on file with Admissions and Records.
3. Submit petition and supporting documentation to the Graduation Office/Admissions Office at Santiago Canyon College.
This petition is valid for 2 years, and it is valid only for the catalog year and major which you list below.
First Middle Last Student ID
Address City St Zip Phone
E – mail Address
Major Catalog Year
I hereby petition to substitute the following course: __________________________________________ with the
Course required at Santiago Canyon College
following course: _________________________________________________________________________ from
Course Number and Title
____________________________________________________. Units________ Grade ________
Name of College/University where course was taken
Rational for this request: ___________________________________________________________________________
Student Signature Date
FOR OFFICE USE ONLY
This petition has been reviewed by the Graduation Specialist. The decision is indicated below.
Graduation Specialist: ___________________________________ Approved / Needs further review Date: ________________
This petition has been reviewed by the appropriate department and division. The decision is indicated below.
Department Chair: ________________________________________ Approved / Denied Date: ________________
Division Dean: ____________________________________________ Approved / Denied Date: ________________