Ventura College
APPLICATION FOR DEPARTMENTAL PROFICIENCY AWARD
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Print name as you wish it to appear on certificate.* Previous name(s) if any.
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Mailing Address City State Zip
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Student I.D. Number Birthdate Contact Phone Email Address
NAME OF PROFICIENCY AWARD _________________________________________________________________
Requirements completed by end of term: FALL, 20 _____ SPRING, 20 _____ SUMMER, 20 _____
OTHER COLLEGES ATTENDED __________________________________________________________________
Attach an unofficial Ventura College transcript and official transcripts from other colleges if coursework is being used for this award.
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CLASSES REQUIRED FOR PROFICIENCY AWARD: Catalog Year ____-____ Units Units in
Completed Progress
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No. Units at VC: _________ _________
Total Award units: _________ _________
Cumulative GPA (2.0 or higher): ________________
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Student Signature Date
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DEPARTMENT DECISION:
This application has been evaluated and it has been determined that the student: _____ has _____ has not
met the requirements for this Proficiency Award.
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Authorized Department Signature Date
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Print Name
Student notified of Department Decision on ______________________________________
Date
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