Date Stamp
Petition for Certificate of
Admissions and Records Office Achievement/Accomplishment
2600 Mission Bell Dr. (Instructions on back)
San Pablo, CA 94806
510.215.6027 fax 510.412.0769
Semester you will graduate (see back for deadlines):
Fall Spring Summer
Print your full name “EXACTLY” as you would like it to appear on your certificate:
First Middle Last
Student ID # _______________________________ Date of Birth: ______________________________
Address: ___________________________________ _________________________________________
Street Name Apartment # City State ZIP Code
Do you have transfer credit from another college that will apply to this Certificate? Yes No
If yes, are your official transcripts on file in A&R? Yes No
List Colleges: _________________________________________________________________________
Do you have AP, CLEP or IB Credits to apply? Yes No Are you a veteran? Yes No
Administration of Justice:
Correctional Specialist
Forensic Criminalist
Law Enforcement
Pre-Law Studies
Police Services Specialist
Security Specialist
Automotive Services
Automotive Collision Repair Technology
Automotive Hybrid Technician
Automotive Service Technician
Chassis Level I Technician
Powertrains Level 1 Technician
Automotive Collision Repair- Damage
Biological Science
Biotechnology Assistant
Biotechnology Technician
Pre-Allied Health
Accounting Technician
Business Administration
Business Management
Business Office Technology
Administrative Assistant
General Office
Computer & Communications Technology
Network Technology
Computer Information Systems
Computer Operations
Computer Programming
Culinary Arts
Classical/Modern Food Preparation &
Restaurant Training
Training in Pastry & Baking Skills
Early Childhood Education
Early Childhood Education
Associate Teacher-Preschool
Associate Teacher School Age Children
Montessori Education: Preschool Teacher
Montessori Education: Preschool Teacher
Automotive Services
Auto Technology
Auto Collision Repair Technology
Emergency Medical Services
Emergency Medical Services
Health & Human Services
Human Services
Dual Diagnosis Specialization
Liberal Arts
Science, Technology, Engineering and Math
Digital Film Production
Medical Assisting & Office Technician
Medical Assisting & Office Technician
Health Navigator
Computer Repair Technology
Fiber Optic/Copper Network Structure
Network Communication Technology
Security Systems/Home & Small Business
Wireless Networks/Home & Small Business
Basic Food Service
Restaurant Management
Advanced ESL
High-Intermediate ESL
Low-Intermediate ESL
Geographical Information Systems
Dual Diagnosis Screening (HHS)
Peer Support Services (HHS)
Psychosocial Rehabilitation (HHS)
Substance Abuse Case Management (HHS)
Medical Terminology
Fitness Trainer
Personal Training Prep Course
The programs in this column are not eligible for
financial aid.
Student Signature: _______________________________________________________________________
click to sign
click to edit
Instructions: Please complete this form with the help of your counselor. You may graduate with multiple
certificates and degrees. If you also want to receive a degree for the certificate you are applying for, please
complete the Petition for Degree form as well.
Filing Deadlines: Submit your Petition for Certificate to Admissions and Records by the following deadlines:
March 1: Graduating Spring and participating in Graduation Ceremony in May
July 15: Graduating Summer
October 15: Graduating Fall
Graduating with Honors:
Honors Graduate: Earning a cumulative GPA between 3.25 and 3.74 in all degree applicable units
President’s Scholar: Earning a cumulative GPA of 3.75 or higher in all degree applicable units
Catalog Rights: If continuous enrollment is maintained by enrolling in at least one course at CCC, DVC, or
LMC in an academic year (Summer, Fall, Spring) students are guaranteed rights to the catalog requirements in
effect during their initial term of enrollment. Should catalog requirements change while continuous enrollment is
maintained, students may utilize any subsequent catalog in effect to graduate. Students may not use a different
catalog to graduate with a degree once a certificate is awarded.
Graduation Checklist: Use the following checklist to make sure that you have completed all steps necessary to
complete your degree evaluation.
1. I have met the minimum number of units required from Contra Costa College to meet the residency
2. I have completed all requirements with a “C” grade or higher
4. I have official transcript from other institutions attended on file with Admissions and Records Office
5. I have AP/CLEP/IB documents on file with Admissions and Records Office
6. I have recently met with a counselor to review the completion of degree requirements
Printing of Certificates:
At the end of the semester, your evaluator will review the grades received for the semester. This process takes
6-8 weeks to complete. You will receive an email notification when your certificate is ready for pick up.