Fillable central oregon community college TEACHER APPROVAL REQUEST form

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central oregon community college TEACHER APPROVAL REQUEST form

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U.S.A. forms for Central Oregon Community College

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Revised 6/19/2019
TEACHER APPROVAL REQUEST
Full Legal Name ______________________________________ Date
Address _______________________________________ Date of Birth
Social Security No. _________________High School
Phone Number_______________________ Email
Have you ever taken any classes (credit, Community Learning) at COCC?
I request approval to articulate the following classes for the College Now program:
ARTICULATION
COCC COURSE NO. COCC COURSE NAME START DATE
_______________ _______________________________
_______________ _______________________________
_______________ _______________________________
LIST DEGREES
Associates
College/year received
Bachelors
College/year received__________________________________________________________
Masters
College/year received
LIST OTHER ENDORSEMENTS / LICENSES AND DATES
____________________________________________________________________________
____________________________________________________________________________
LIST RELEVANT COLLEGE-LEVEL COURSES TAUGHT
Dates Institution Courses Taught
____________________________________________________________________________
____________________________________________________________________________
LIST CASCADES COMMITMENT PARTICIPATION
Dates Course(s)
____________________________________________________________________________
____________________________________________________________________________
Attach an unofficial copy of your transcripts and a resume to this form.
Send all documents to:
Cady-Mae Koon – ckoon@cocc.edu or
College Now Office
Central Oregon Community College
2600 NW College Way, Bend, OR 97703
Phone: (541) 504-2930 / Fax (541) 317-3071
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central oregon community college TEACHER APPROVAL REQUEST form

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Completed 21 December 2019

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