Student Signature:________________________________ Date ____________ Date of Birth : ____________________

List of other colleges attended: __________________________________________________________________________

CERRITOS COLLEGE Petition for Associate in Arts Degree

PRINT NAME CLEARLY & EXACTLY AS IT IS TO APPREAR ON THE DIPLOMA

First Name Middle Name Last Name

Email Address: ___________________________________________ Message Phone: _________________________

Semester Year

Student ID Number

Academic Plan / Major

Do NOT write below this line. (STAFF USE ONLY)

Proficiencies

Mathematics

Writing

Reading

Health & Wellness

General Education– Plan A

A & R Staff Use Only

Awarded Honors

Awarded Highest Honors

Postcard Sent

Degree Name

PendingDegree Posted

Matriculated Degree Mailed ____/____/____

Approved Denied Withdrawn

Status of Petition:

Natural Sciences

Social & Behavioral Sciences (Must be American History or Ameri-

can Government)

Fine Arts & Humanities

English Composition

Comm/Analytic Thinking

Additional course if needed from

above categories or from plan B or Plan C

to reach 18 unit minimum

Units Course

SEMESTER ENDING Attempted Earned Grade GPA

Non Degree Applicable

courses

Transfer Credits

Work In Progress

Total

Graduation Evaluator Date

Comments:

Total Units:

AA DEGREE 1ST 2ND 3RD

Academic Plan (Major Code)

Catalog Year: Major

Major Requirements still to be met:

Course Name Units in

Progress

Incomplete

Units

Comments:

Signature:

Evaluator / Counselor Date

Email Address: _____________________________ @ ______________ Message Phone: _________________________

Student Signature:________________________________ Date ____________ Date of Birth : _______/ _______ / ________

List of other colleges attended: __________________________________________________________________________

CERRITOS COLLEGE Petition for Associate in Arts Degree

PRINT NAME CLEARLY & EXACTLY AS IT IS TO APPREAR ON THE DIPLOMA

First Name Middle Name Last Name

Semester Year

Student ID Number

Academic Plan / Major

Email Address: _____________________________ @ ______________ Message Phone: _________________________

Student Signature:________________________________ Date ____________ Date of Birth : _______/ _______ / ________

List of other colleges attended: __________________________________________________________________________

CERRITOS COLLEGE Petition for Associate in Arts/Science Degree for Transfer

PRINT NAME CLEARLY & EXACTLY AS IT IS TO APPEAR ON THE DIPLOMA

First Name Middle Name Last Name

Do NOT write below this line. (STAFF USE ONLY)

General Education– Plan B or Plan C

A & R Staff Use Only

Degree Name Awarded Honors

Pending Awarded Highest Honors

Degree Posted Postcard Sent

Matriculated Degree Mailed ____/____/____

AAT Evaluation Sent Approved Denied Withdrawn

Status of Petition:

SEMESTER ENDING Attempted Earned GPTS GPA

Non Degree Applicable

courses

Transfer Credits

Work In Progress

CSU Transferrable Units

Graduation Evaluator Date

Comments:

Total Units:

AA DEGREE 1ST 2ND 3RD

Academic Plan (Major Code)

Catalog Year: Major

Major Requirements still to be met:

Course Name Units in

Progress

Incomplete

Units

Comments:

Signature:

Evaluator Date

Semester Year

Student ID Number

Academic Plan / Major

Check here if you are transferring to the CSU system and wish to apply for an AAT

or an AST degree

GE Requirements still to be met:

Course Name Units in

Progress

Incomplete

Units

Subject Requirements Still to be Met:

Units & Grade Summary:

Units in

Progress

Incomplete

Units

Total Units

SEMESTER ENDING Attempted Earned GPTS GPA

A & R Staff Use Only

Degree Name Postcard Sent

Pending Certificate Mailed ____/____/____

Certificate Posted

Matriculated

Approved Denied Withdrawn

Status of Petition:

Comments:

Comments:

Evaluator Signature:__________________________________ Date : _______________

Course Name

Academic Plan (Major Code)

Catalog Year: Major

Graduation Evaluator Date

Email Address: _____________________________ @ ______________ Message Phone: _________________________

Student Signature:________________________________ Date ____________ Date of Birth : _______/ _______ / ________

List of other colleges attended: __________________________________________________________________________

CERRITOS COLLEGE Petition for Certificate of Achievement

PRINT NAME CLEARLY & EXACTLY AS IT IS TO APPEAR ON THE DIPLOMA

First Name Middle Name Last Name

Do NOT write below this line. (STAFF USE ONLY)

Semester Year

Student ID Number

Academic Plan / Major

What is a digital signature?