Scholars’ Honors Program
Cerritos College
11110 Alondra Boulevard
Norwalk, California 90650-6298
(562) 860-2451 ext. 2728
1. Fill out the online form. Handwritten forms will not be accepted.
2. PRINT THE FORM and put it in the Director's Mailbox in the Liberal Arts building (2nd floor)
Personal Details (mandatory section)
First Name: Last Name:
Student ID#: Date of Birth:
Address: City, State & Zip Code:
Home Phone: Cell Phone:
Name of High School: Location (City):
Did you graduate? YES NO Date of Graduation:
Transfer Information (mandatory section)
Major 1: Major 2:
Expected Date of Graduation/Transfer (Semester / Year):
Preferred transfer institutions (check all that apply):
UC Berkeley UC Davis UC Irvine UCLA
UC Riverside UC San Diego UC Santa Barbara UC Santa Cruz
Other: Other:
Other: Other:
Academic Information (mandatory section)
I have completed the prerequisites to these college courses with grades of C or better:
English 100: Freshman Composition YES NO
Math 80: Intermediate Algebra YES NO
Academic Information continued (mandatory section)
I have taken the Cerritos College placement tests and my placement scores are:
English Placement Test YES NO Course #:
Mathematics Placement Test YES NO Course #:
Number of AP Exams Completed with a 3, 4, or 5:
Cumulative GPA from High School (unweighted):*
Number of Transferable Units from Cerritos College:* Cumulative GPA:
Number of Transferable Units from Other College:* Cumulative GPA:
* A minimum of a 3.0 GPA is required of all students (high school applicants and college applicants)
Eligible to Complete Honor Writing Requirement (mandatory section)
All applicants must complete the Honors Writing Requirement at Cerritos College in order to complete
the SHP. A “Yes” response is required of all applicants to the questions below; if you are unable to
answer “Yes,” then you will be denied admission into the SHP.
I agree to complete the honors section of English 100 and/or English 103 at Cerritos College.
I understand that if I do not complete the Honors Writing Requirement, I will not be certified as an
honors student.
I certify the above information to be true and correct to the best of my knowledge. I authorize all
schools named above to release all academic transcript information about me to the Scholars'
Honors Program at Cerritos College. I authorize the Cerritos College Scholars' Honors Program to
release my name to accredited colleges and universities for transfer purposes.
Signature of Applicant Date
click to sign
click to edit
1. Complete all the "mandatory" sections. Your application will not be processed if you do not
complete those sections. Print this form once you complete it. Handwritten forms will not be
2. Your application must include your English and Math placement scores or proof that you have
successfully completed these two requirements. Your application will not be processed withoutthis
3. You must submit a copy of your transcripts (unofficial transcripts are acceptable) to the SHP. Please
note: if you have not completed at least 12 units at Cerritos College, you will need to send us your high
school transcripts. Do not send us a copy of your Cerritos College transcripts if you have not earned
any units. Deliver your transcripts to the SHP Office. Your application will not be processed if you do
not submit your transcripts.
4. If you have completed any honors courses prior to joining the SHP, list them below. Include the
course name, course number, and the semester you took the course.
5. If there is any additional information that you wish to share, include it in the box below. Please
explain any gaps (time you were not in college) in your education.